universal health care

It's good news that the Supreme Court split 5-4 with Roberts (and not Kennedy?!?) as the deciding vote, to uphold the affordable care act. It's interesting that this was controversial, and certainly Roberts led the court to a very safe middle ground making the issue about taxation and saying the commerce clause could not apply. If anything, I wonder if this weakens the previous commerce powers of Congress as defined by Wickard v. Filburn, I'd love to hear what a lawyer thinks. What does this mean? Well in the short term not a whole lot, this healthcare bill requires a very slow roll-out…

The NYTimes reporting suggests a 5-4 split against ACA is likely: Justice Kennedy, along with Justices Samuel A. Alito Jr. and Antonin Scalia and Chief Justice John G. Roberts Jr. all asked questions suggesting that they had a problem with the constitutionality of the mandate requiring most Americans to buy insurance. Justice Clarence Thomas, as usual, did not ask any questions, but he is widely expected to vote to overturn the mandate. As does CNN's Toobin's analysis: This is interesting. Part of the issue is how much of the law would fall if they turn against it? Would we still be able…

We've written quite a bit about single payer health care systems as well as other models that are a mixture of public and private spending. We've also analyzed some of the sources of excess cost of US healthcare to other countries. What is uniformly true about universal health care systems is that they all spend less on medical care per capita than the US. The next nearest country in spending to us, France, spends 50% of what we do per capita while providing top notch care, possibly the best in the world. And while the cause of our excess costs are multifactorial, one of the greatest…

Clearly, I'm not the only one who thinks that the most obvious solution for health care reform is for the House to pass the Senate bill: The New York Times just published an editorial arguing the same point: The most promising path forward would be for House Democrats to pass the Senate bill as is and send it to the president for his signature. That would allow the administration and Congress to pivot immediately to job creation and other economic issues. The Senate bill is not perfect, but it would expand coverage to 94 percent of all citizens and legal residents by 2019, reduce the deficit…

It's been a rocky ride this year, getting heath care bills passed in the House and the Senate. It's been just over a month since the Senate passed its bill in a dramatic Christmas Eve vote (and much longer since the House passed its version), but the fate of health care reform still appears as uncertain as ever. In particular, a surprising political setback in Massachusetts has made the already difficult Senate an almost impossibly hostile environment for reform. The most obvious solution is for the House to pass the Senate bill without hesitation; however, House Speaker Nancy Pelosi has…

I recently had the pleasure of writing an op-ed piece about health care reform for my hometown newspaper, the Fort Worth Star-Telegram, and it ran in the paper today. You can check it out online here. I grew up reading the Star-Telegram, so this was an exciting opportunity. My article discusses the need for robust health care reform in the form of a strong public option, comparing and contrasting my health care experiences in the US and the UK to build my case. For regular readers of my blog, you will note that this is a theme I have often explored. I would have preferred that the Star-…

Despite rumors to the contrary, I am not dead. Instead I've been working hard as a new surgical intern and sadly not finding the time to write for the denialism blog. However, now more than ever, it seems that we need to talk about the problem of denialism. Two major new issues for denialism have cropped up, and both are major new forms of political denialism. The first, I'll broadly describe as Obama-denialism. Obama is a muslim, Obama was not born in the US, there is a giant conspiracy involving the Hawaii Secretary of State, the Democratic Party and muslims worldwide to take over the…

Mike Dunford tells a compelling story today at The Questionable Authority: Yesterday, I took the kids to the doctor for their school physicals. I wouldn't normally subject you to an account of the day-to-day minutia of my personal life, but given the current debate about how we should handle health care in the United States, the details might be of interest. We arrived - without an appointment - at a medical facility that we had not been to before. We did not have medical records with us, and the only paperwork of any kind that we had brought were the forms that needed to be filled out to…

The question has come up again and again in our discussions on health care in the US and around the world, why does it cost so much more in the US when we get so much less? The drug companies and their lobbyists are already out in force trying to make sure their pocketbooks aren't hit by the inevitable reforms that are coming. In particular they insist drugs aren't the problem in the US, it's administrative costs! I would tend to disagree. Based upon my experience working in the sytem, the main causes of excess costs I would hypothesize are the following (in order of importance): An…

Here it comes. How dare I suggest the US could learn anything from France? By most assessments France provides the best health care in the world, with excellent life expectancy, low rates of health-care amenable disease, and again, despite providing excellent universal care, they spend less per capita than the US. Using about 10.7% of GDP and about 2000USD less per capita than the US they are providing the best health care in the world. To top it off, France's system isn't even socialized. That's right. It's yet another system that is a mixture of public and private funding that, if…

What better argument for universal health care can you make than that of Germany? By far one of the most successful systems, it has had some form of universal health care for almost 130 years, and is currently one of the most successful health care systems in the world. It is again, a mixture of public and private funding, with employers providing most of the funding for health care by paying into one of several hundred "sickness funds" that provide health care funding to their employees. Germany is widely regarded as having excellent access, short wait times, care with the best…

The Dutch really have it together on health care, they have a system that has been proposed as a model for the US to emulate. In stark contrast to many other European systems, it's actually based entirely on private insurers, rather than a single-payer or entirely national system. Yet the Dutch system is universal, has far superior rates of satisfaction with quality of care and access, and still costs a fraction of what we pay for health care per capita in the US. How is this possible? You can read the Wikipedia entry on the Dutch system or read about it on their Ministry of Health's…

To start off some balanced discussions of what universal health care looks like around the world, I thought I would begin with Australia, a system that we could learn a great deal from. In the US system, we do not have universal healthcare, we have mostly employer-subsidized healthcare, private insurance and medicare covering people's health expense. We also lack a universal electronic medical record, our main recourse for responding to poor care is lawsuits, and we have a high disparity in services available to those with money and those who do not. We still manage to spend more on…

A dishonest campaign has started against healthcare reform in this country and the first shot has come from Conservatives for Patients Rights (CPR), a group purporting to show that patients in universal health systems suffer from government interference in health care. To bolster their argument, they have a pile of anecdotes from people around the world who have suffered at the hands of evil government-run systems. The problem, of course, is that anecdotes are not data, it is impossible to determine the veracity or reasonableness of these claims, and there is no way, ethically or…

I was pleased to see president Obama deliver this address yesterday: Click To Play I was even more pleased because he has gathered the traditional opponents of healthcare reform around him and has convinced them to commit to reform in the US system. This is a positive sign. However, I'm concerned because, as with all political debates that challenge a dominant ideology - in this case free-market fundamentalism - we will soon see the denialists come out of the woodwork to disparage any attempt at achieving reforms that may result in universal health care coverage. This has, in fact,…

As part of the stimulus package passed by Congress last Friday (H.R. 1: American Recovery and Reinvestment Act of 2009), the US will be ramping up efforts to encourage evidence-based medicine. This is a very good thing. Specifically (from The New York Times): The $787 billion economic stimulus bill approved by Congress will, for the first time, provide substantial amounts of money for the federal government to compare the effectiveness of different treatments for the same illness. Under the legislation, researchers will receive $1.1 billion to compare drugs, medical devices, surgery and…

Last night was a historic night, with Barack Obama finally effectively clinching the Democratic nomination by surpassing the "magic number" of required delegates. Barring any last-minute fight over delegate rules from Hillary Clinton's campaign (something that I think is not likely to happen), Barack Obama in the Democrats' nominee. Of course, we knew from the beginning that 2008 was going to be a trailblazing election--we just didn't know which way it would swing. Although it's been pretty clear since Obama's string of victories in February that he would eventually be the nominee, now it'…

Last Thursday (April 24), the Senate unanimously passed the Genetic Information Nondiscrimination Act of 2008 (GINA, H.R. 493) in a landmark vote. The goal of this bill is "to prohibit discrimination on the basis of genetic information with respect to health insurance and employment," and it therefore would help fill this gaping hole that exists in our current protection of employees' and patients' rights. The bill was passed by the House roughly one year ago by a vote of 420-3, and although it was scheduled for debate in the Senate, it wasn't voted upon until last week. Now, the Senate has…

It's difficult to find too many substantive policy differences between Barack Obama and Hillary Clinton (especially considering the much larger gulf that exists between them and the Republican candidates), but one area that's brought up time and time again is health care. In light of this, it's worth taking a look at how much the two agree and disagree here, especially since health care policy is purportedly one of Clinton's selling points. To look at the actual plans from each of the candidates, you can click here for Obama's and here for Clinton's. The most thorough--but still accessible…

On Monday, Mike the Mad Biologist posted about the sheer idiocy of "choice-based health care," which seems to be so en vogue today in the Republican party and elsewhere. He writes: One of the most ridiculous ideas to come down the pike is the notion that most people, who are woefully ignorant of medicine and biology (e.g., the massive misunderstandings about antibiotics and infectious disease), will actually make intelligent decisions regarding their own healthcare. In fact, I bet most people would do worse than flipping a coin in many situations. That's before you get to the roughly…