Training and Treatment
February 16, 2017
To the Editor:
How ironic that on the day of a teen’s overdose a Narcan training was being held in Amagansett. The Narcan training was well attended; however, in light of the epidemic sweeping our community, we need more training programs such as the one hosted by Origins Behavioral Healthcare.
The community needs as much support as it can get right now. Training and treatment and open hearts and minds will help heal this tragic problem.
Blind Free Market
February 20, 2017
To the Editor:
Blind free-market ideology can be dangerous to your health! Now that we are in the midst of revisiting our health care system, it’s worth drawing a parallel with Switzerland to illustrate how a country that revised its health care system in the ’90s is still struggling today.
Why do I select Switzerland, with a population of only 8.2 million? Because the system is private, federalist (the 26 cantons function somewhat like states), and should normally succeed: The median income of the Swiss is twice that of the United States and offers everyone topnotch health care — and the fact that Ford magazine claimed in 2011 that it was the best health care system in world.
So what is going wrong? Since the Swiss health care overhaul (the LAMAL law of 1994), the number of Swiss health care insurance companies has gone from about 100 to 59 today. That was almost a quarter of a century ago, and they still haven’t optimized their system.
Let me give you a quick illustration that happened in 2015 and was published in the Swiss press. Assura, an insurance company with a reputation for being a pioneer of low-cost premiums for basic insurance plans, saw its reserves suddenly depleted by a mammoth deficit of 253 million Swiss francs (currently the same in dollars). What happened? Their “strategy” of attracting customers with low-cost premiums suddenly backfired: New clients in 2014 grew by 20 percent but medical expenses grew by 27 percent. Almost overnight, they were in trouble.
Another insurance company the same year bought up a smaller one and went from solvency to deficit, because they couldn’t evaluate the health care status of the new clients beforehand. Well, too bad, you might say, poor management. But do market rules really apply in health care? Swiss law compels all insurance companies to offer a basic plan to everyone, which corresponds to the lowest premium rate companies offer. The basic plan is mandatory, and benefits are determined by law.
At year’s end, young, healthy individuals tend to shop around for the best deal, because insurance companies are free to charge what they want for the basic plan and, by the way, new clients cannot be refused for pre-existing conditions. Conversely, the old and sick customers tend to stay put, out of fear of losing add-on benefits they contracted for previously with their current company. The result is that competition among insurance companies tends to breed insolvency, because the basic plan — if underpriced to lure new clients — can drain resources suddenly and unexpectedly. How can anyone claim free-market competition when the buyer and the client are in the dark?
Back to the U.S. Since 2009, the media have blared the need for young, healthy individuals to join the exchanges of the Affordable Care Act so as to compensate for less healthy and older individuals to be included in the same insurance pool. As we embark on the repeal, or the replacement, or A.C.A. repair, it is important to note that free-market ideology is at loggerheads with the profit incentive that makes free-market competition work efficiently, at least in the case of health care insurance companies.
Joe Biden recently said on “60 Minutes” that Democrats consider health care a right, and Republicans, a privilege. Whatever one thinks, my point here is that in a system where insurance companies compete for customers who will most likely not use their products — where customers don’t know what their future needs might be and do not have a decade of medical studies to assess them; where customers know neither the cost nor the specifics, once the bills arrive, and, finally, where outcomes have no objective point of comparison — how can anyone claim that free-market capitalism can jibe with a health care market?
It’s the politics, stupid!
Our Best Hope
February 20, 2017
There are four things that everyone needs to know about the Republican plan to repair Obamacare and why it simply will not work.
First, Medicaid block grants to the states to replace Medicaid plans on the exchange will result in many states lowering their income threshold for families to qualify for Medicaid. This means that there will be fewer eligible families and many families will be left without coverage.
Second, tax credits replacing Obamacare premium subsidies to help families pay for insurance premiums will never be enough to cover the ever-increasing premiums, eventually leaving many lower-income families without coverage.
Third, medical savings accounts have the unintended consequences of families forgoing preventive care so as not to deplete the funds. This is a problem, because preventive care not only keeps people healthier but may allow for earlier detection of illnesses that can result in costly care. Ultimately the taxpayers end up paying for these high costs through emergency room visits for people with insufficient insurance.
Fourth and last, proposed state high-risk pools historically have not been robust enough to cover very serious high-cost illnesses such as cancer and immune diseases like lupus and rheumatoid arthritis.
All these issues show why a single-payer Medicare for all is our best hope for universal health care in the future. Medicare premiums adjusted to income can cover all Americans, regardless of age or health history. Medicare works for seniors, why can’t it work for all? It is no secret that people do not want their Medicare touched — they like it!
We hope that our congressman, Lee Zeldin, does his own research and realizes that his support for the Republican plan to repair Obamacare will have many unintended consequences and should not be passed.
People Just Die
February 20, 2017
It has recently come to my attention that Congressman Lee Zeldin favors “redirecting” money from Planned Parenthood (for no stated reason) and giving such money to other women’s health agencies (not specified). Why? Isn’t that like convicting someone without a trial? If he thinks they have done something wrong then they deserve their day in court, not ideology and politics.
As I’m sure many of your readers are aware, Planned Parenthood offers many important lifesaving services — and high quality ones at that. This organization has not broken the law in any way to justify defunding it.
Mr. Zeldin hides behind the fact that he has daughters and a wife, as though that makes him somehow untouchable in his opinions on women’s care. Having a family that includes females is not an excuse for limiting women’s services. He and his family are privileged and can get the best health care treatment available. As a congressman and federal employee, he and his family have good health insurance through his employer, the United States government. But there are thousands of American women who, unfortunately, do not have these benefits and privileges, and rely on the services of Planned Parenthood. Has he no compassion? And if not, at least look at the bottom line. Without good health care, the rest of us end up paying anyway for those who are not covered — or people just die.
I ask Mr. Zeldin to reconsider his motives, re-evaluate his position, and let American women continue to get the good health care they have been getting via Planned Parenthood. Ideology and politics should be put aside for the good of our citizens.