September 29, 2006
Military Commissions Bill
For those of you who can bear to look, here is a brief overview of the recently passed Military Commissions Bill from TalkLeft.
Universal Health Care
The New York Times reported earlier this week that an advisory panel appointed by the Comptroller General concluded that "Congress should take immediate steps to guarantee that all Americans have access to affordable health care by 2012." The Times reports,
The panel, the Citizens’ Health Care Working Group, said Congress should create an independent “public-private entity” to define a basic set of health care benefits and services for all Americans.
While leaving many details to be worked out, the panel declared, “It should be public policy, written in law, that all Americans have affordable access to health care.”
The panel was created by the 2003 law that added a drug benefit to Medicare. Under the law, President Bush has 45 days to comment on the recommendations and offer a report to Congress. Five Congressional committees are then supposed to hold hearings on the proposals. . . .
The number of uninsured Americans keeps growing despite fluctuations in the economy, and the report from the working group increases the chances that health care will be a major issue as candidates gear up for the 2008 presidential race.
Census Bureau figures show that 39.7 million people lacked health insurance in 1993, when President Bill Clinton took office. The number rose, to 44.3 million in 1998, and then began to decline. Since 2001, when President Bush took office, the number of uninsured has increased by more than 5 million, to 46.6 million in 2005.
September 28, 2006
Dr. Pou's Case
During the awful events of Hurricane Katrina, four patients died of lethal doses of morphine while in the care of Dr. Pou and two nurses as they waited for help at the New Orleans' Memorial Medical Center during Hurricane Katrina. It is unclear whether the doctor engaged in a form of mercy killing or was attempting to relieve patient pain and suffering. The Louisiana Attorney General, Mr. Foti, apparently believes the former. Talkleft reports that the Louisiana State Medical Society has come out in defense of Dr. Pou. The Talkleft blog and the Kevin, MD Medical Blog provide some helpful background on this case. Dr. Pou appeared on 60 Minutes this past weekend to discuss her case and explain how she did not murder her patients.
Walmart Moves to HSAs
Erza Klein has the latest information on Walmart's decision to stop offering what little traditional health care plans it did offer and move to high-deductible HSAs. After briefly describing the plan, he concludes,
This, of course, is only further evidence that it's time to stop making Wal-Mart offer decent health care -- which they will clearly not do -- and simply rip the responsibility away from them, ensuring all of their "associates" have generous, serious coverage they can fall back on.
More worryingly, Target has promised the same move. Which'll mean that the two largest retailers will both eschew traditional health care plans for low-cost (to the company), high-risk (to the employee), astonishingly stingy offerings. Now, of course, any retailers who seek to compete with them -- and that includes supermarkets, clothing outlets, and all the rest -- will be at a competitive disadvantage if they fund traditional health care plans for their employees.
September 26, 2006
Lung Transplants and Waiting Lists
The New York Times reported on Sunday interesting and good news about the recent rather dramatic decrease in waiting time for certain individuals for lung transplants. The Times reported some of the reasons, a new allocation method, more organ donors, and better technology:
Recent changes have revitalized lung transplantation. Starting in May 2005, new rules nationwide put patients who needed transplants most at the top of the list — people who would soon die without a transplant, but who had a good chance of surviving after one.
Previously, lungs went to whoever had been waiting longest, even if another patient needed them more. The waiting time was often two years or more, so there was little hope for people with lung diseases that came on suddenly or progressed rapidly.
Another major change is that more lungs from cadavers have become available, for two reasons: more people are becoming organ donors, and doctors have figured out ways to salvage lungs that previously would have been considered unusable. The new methods use drugs, respirator settings and other techniques to prevent damage to the lungs and keep their tiny air sacs open in brain-dead patients.
In the past, lungs could be retrieved from only about 15 percent of organ donors, but at some centers the rates have risen to 40 percent. Dr. Herrington said that in Minnesota, the number of lungs retrieved went to 97 from 25 in a single year.
Unmotivated by Money?
Professor Paul Caron at TaxProfBlog posts the results of a Harvard Graduate School of Education survery that shows that faculty members care more about treatment than money. I am not sure that is correct for all members of the academy but it does ring somewhat true to me. Professor Caron states,
A press release issued today by the Harvard Graduate School of Education reports that New Study Indicates Faculty Treatment Matters More Than Compensation; Survey of 4,500 Tenure-Track Faculty Reveals Surprising Findings:
A new study by the Collaborative on Academic Careers in Higher Education (COACHE), a research project based at the Harvard Graduate School of Education, has revealed that climate, culture, and collegiality are more important to the satisfaction of early career faculty than compensation, tenure clarity, workload, and policy effectiveness.
The survey of 4,500 tenure-track faculty at 51 colleges and universities discovered that there are key climate variables for junior faculty, such as: interest senior faculty take in their work, fairness with which they are evaluated, opportunities to collaborate with senior faculty, how well they seem to fit in their departments, sufficient professional and personal interaction with colleagues, and a sense of community in the department. The survey revealed that collegiality matters much to the success and satisfaction of new scholars, in stark relief to studies of an earlier generation that showed autonomy was one of the most important attractions to academic life.
Quite frankly, part of the attraction of teaching is working in an environment that is different from the typical law firm or in-house corporate position and,while autonomy is an important part of that, so is the opportunity to share ideas and thoughts with other individuals who also enjoy studying the law.
September 25, 2006
Right to Die: Views from the Ambulance
Professor Seth Chandler, Foundation Professor of Law and Co-Director Health Law & Policy Institute, sends the following excerpt from a London ambulance driver's blog. It is very moving.(http://randomreality.blogware.com/blog/_archives/2005/9/5/1194694.html)
Donuts: Not Just for Breakfast
More and more seniors are suddenly discovering the Medicare Part D Donut Hole, according to Ezra Klein, writing at Tapped, and the discovery is not pretty (and that is putting it very mildly). He writes,
Millions of seniors are about to tumble into the donut hole, a coverage gap that extends (usually) from $2,250 to $3,600, at which point federal insurance kicks back in. Most seniors, as we already knew, were unaware of the gap. And this is what it looks like when they fall in it:
Frances Acanfora, 65, had been paying $58 for a three-month supply of her five medications. But this month the retired school lunchroom aide learned that her next bill would be $1,294. She had entered the doughnut hole.[...]
After talking to her doctor, Acanfora decided to temporarily stop taking a drug as part of her treatment for breast cancer. She hopes to obtain some free samples of eye drops for her glaucoma. Three other medicines -- for high cholesterol, diabetes and osteoporosis -- cost $506.62, which Acanfora put on her credit card.
"I pay a little bit at a time," she said. "What am I going to do? I need it. . . . Sometimes, just to think about it, I cry."
In case anyone's wondering about the staggeringly strange structure of it all -- don't. It makes no sense. The concept behind donut holes is that they ensure coverage for basic care, so folks don't skimp on preventive and diagnostic services, then impose a certain level of cost-sharing in order to incentivize all those magical things price-conscious consumers apparently do, then pick up the coverage again for those who are simply ill. It makes a certain amount of sense -- unless you're dealing with prescription medications for seniors.
Ezra has more to say about the subject and its impact on seniors who need their medication. He further notes that this donut hole could be a big problem for politicians this Fall.