Archive for the ‘Medical’ Category
And the letters are full of lies. This is, I contend, a very bad sign. Charles Ornstein reports in ProPublica:
When Louisiana resident Andrea Mongler wrote to her senator, Bill Cassidy, in support of the Affordable Care Act, she wasn’t surprised to get an email back detailing the law’s faults. Cassidy, a Republican who is also a physician, has been a vocal critic.
“Obamacare” he wrote in January, “does not lower costs or improve quality, but rather it raises taxes and allows a presidentially handpicked ‘Health Choices Commissioner’ to determine what coverage and treatments are available to you.”
There’s one problem with Cassidy’s ominous-sounding assertion: It’s false.
The Affordable Care Act, commonly called Obamacare, includes no “Health Choices Commissioner.” Another bill introduced in Congress in 2009 did include such a position, but the bill died — and besides, the job as outlined in that legislation didn’t have the powers Cassidy ascribed to it.
As the debate to repeal the law heats up in Congress, constituents are flooding their representatives with notes of support or concern, and the lawmakers are responding, sometimes with form letters that are misleading. A review of more than 200 such letters by ProPublica and its partners at Kaiser Health News, Stat and Vox, found dozens of errors and mischaracterizations about the ACA and its proposed replacement. The legislators have cited wrong statistics, conflated health care terms and made statements that don’t stand up to verification.
It’s not clear if this is intentional or if the lawmakers and their staffs don’t understand the current law or the proposals to alter it. Either way, the issue of what is wrong — and right — about the current system has become critical as the House prepares to vote on the GOP’s replacement bill Thursday.
“If you get something like that in writing from your U.S. senator, you should be able to just believe that,” said Mongler, 34, a freelance writer and editor who is pursuing a master’s degree in public health. “I hate that people are being fed falsehoods, and a lot of people are buying it and not questioning it. It’s far beyond politics as usual.”
Cassidy’s staff did not respond to questions about his letter.
Political debates about complex policy issues are prone to hyperbole and health care is no exception. And to be sure, many of the assertions in the lawmakers’ letters are at least partially based in fact.
Democrats, for instance, have been emphasizing to their constituents that millions of previously uninsured people now have medical coverage thanks to the law. They say insurance companies can no longer discriminate against millions of patients with pre-existing conditions. And they credit the law with allowing adults under age 26 to stay on their parents’ health plans. All true.
For their part, Republicans criticize the law for not living up to its promises. They say former President Obama pledged that people could keep their health plans and doctors and premiums would go down. Neither has happened. They also say that insurers are dropping out of the market and that monthly premiums and deductibles (the amount people must pay before their coverage kicks in) have gone up. All true.
But elected officials in both parties have incorrectly cited statistics and left out important context. We decided to take a closer look after finding misleading statements in an email Sen. Roy Blunt, R-Mo., sent to his constituents. We solicited letters from the public and found a wealth of misinformation, from statements that were simply misleading to whoppers. More Republicans fudged than Democrats, though both had their moments. . .
Continue reading. Good examples of bad faith.
Margo Sanger-Katz reports in the NY Times:
The Congressional Budget Office recently said that around 24 million fewer Americans would have health insurance in 2026 under the Republican repeal plan than if the current law stayed in place.
That loss was bigger than most experts anticipated, and led to a round of predictable laments from congressional Democrats — and less predictable ones from Republican senators, including Bill Cassidy of Louisiana and John Thune of South Dakota, who told reporters that the bill needed to be “more helpful” to low-income people who wanted insurance.
But one piece of context has gone little noticed: The Republican bill would actually result in more people being uninsured than if Obamacare were simply repealed. Getting rid of the major coverage provisions and regulations of Obamacare would cost 23 million Americans their health insurance, according to another recent C.B.O. report. In other words, one million more Americans would have health insurance with a clean repeal than with the Republican replacement plan, according to C.B.O. estimates.
The C.B.O. estimated what would happen after a simple repeal when it considered a bill that Congress passed last year. (President Obama later vetoed that bill.) The bill left parts of Obamacare in place, so the 23 million estimate didn’t come with the kind of detailed analysis that accompanied last week’s score of the American Health Care Act. But the similarity of the two estimates highlights some of the difficulties of the current proposal, both for Democrats, who are strongly criticizing potential coverage losses, and for the repeal-or-die crowd, who hate the structure of this new bill.
“It’s reaffirmed how exceedingly complicated and convoluted the approach the House leadership took,” said Dan Holler, the vice president for communications and government relations at Heritage Action, an advocacy group firmly in the repeal-or-die camp.
Late Monday, House leadership revealed a set of amendments to the bill, which will be considered when the bill comes up for a vote. But, if they are adopted, the changes are unlikely to have major effects on overall coverage numbers. If anything, the changes might lead to a larger increase in the number of Americans without health insurance.
The people who would end up without health insurance are slightly different in the two cases. The current bill would cause more people to lose employer insurance, while a straight repeal bill would most likely cause more people who buy their own coverage to become uninsured. . .
That’s from a Kevin Drum post, which you should read.
Ben Hattem reports in Politico:
On the evening of July 19, 2010, Major General Dana Pittard, the new commander of Fort Bliss in El Paso, Texas, got a call from the base’s 24-hour duty officer. A SWAT team had been sent to the house of a young sergeant named Robert Nichols. Nichols was inside with a gun, threatening to kill himself.
Pittard arrived at the soldier’s home just in time to see the soldier step out of the house, put the gun to his chest and fire. Neighbors and police crowded the street, but Pittard was the only officer from the Army base at the scene. He went home, where his boxes were still packed from his move 10 days before, feeling disturbed and helpless.
Nichols was the first of Pittard’s soldiers who died under his command at Fort Bliss. Others followed. A soldier from Fort Bliss’ 11th Air Defense Artillery brigade, which had recently returned from a tour in the Middle East, committed suicide. Another from the same brigade soon overdosed on prescription drugs.
The rash of deaths caught Pittard off guard. He knew that suicide was a growing concern for the military, which had spent millions of dollars to tackle the crisis and had issued dozens of reports—including a 350-page study that called suicides and deaths linked to high-risk behavior an “Army-wide problem.” But going in Pittard hadn’t planned to focus on the issue. That changed quickly. With suicides mounting at his base—a sprawling complex of 30,000 personnel, larger than Rhode Island—he realized he wanted to make stopping what he saw as preventable deaths a top priority.
He conferred with the brigade commanders. Then, he told his sergeant major, only half in jest, that they should put a moratorium on death at the base. “People laughed,” says Pittard, “but I said, ‘no, seriously, let’s look at the roots and causes and do all we can to make it preventable.’”
His solution had the hallmarks of a commander confronted with a stubborn enemy: decisive action and situational adaptability. Pittard aggressively expanded mental health services at the base. He increased the number of mental health staff, created new social spaces and nighttime services, treatment for substance abuse and post traumatic stress disorder. And Pittard made the services available to all soldiers—whether or not there was any reason to believe they were at risk of killing themselves—because he believed everyone was vulnerable to suicide. It was a position that put him at odds with commonly held views in the Army, which tends to regard suicide as something that only a small number of abnormal soldiers are at risk of trying.
His belief was rooted in a personal struggle. He later made public, in a radically un-Army-like moment, something that could have seriously jeopardized a career that some say was destined for the upper echelons of the military: that he had sought mental health care for depression. People who worked at the fort say Pittard’s openness made it easier for soldiers to seek treatment. “I admired him sharing that story,” said Jamie Spanski, a staff sergeant who was stationed at Fort Bliss from 2012 until she left the Army in 2015. “No matter who you are or what rank you are, we’re all just human beings and sometimes you need help.”
And his efforts seemed to work. In 2010, Fort Bliss had 12 suicides, according to published media reports. The next year there were seven. In 2012, when the suicide rate for the Army as a whole peaked at 29.9 deaths per 100,000 people—Fort Bliss had five. It was the lowest suicide rate of any major Army installation in the world. The Defense Department touted Pittard’s accomplishments in news releases and internally; the Pentagon still highlights Fort Bliss’ example as one of the military’s most successful prevention programs.
Experts say the initiatives Pittard implemented at Fort Bliss demonstrate exactly the types of programs required for the Army to turn back its high rate of suicide. But four years after Pittard was transferred, many of the reforms he installed at Fort Bliss have been discontinued, and the base’s suicide rate has climbed again. And the high-ranking officials who pronounced suicide an Army-wide crisis—and who recognized Pittard for his success—haven’t adopted his approach.
Jill Harkavy-Friedman, vice president of research for the American Foundation for Suicide Prevention, called Pittard’s services a “model program.” But, she added, “these things have to be continued to be effective.”
Military suicides used to be rare. Throughout the 20th century, the suicide rate among active-duty service members was lower than the population at large. But after the United States invaded Iraq in 2003, the numbers began to climb. In 2006, for the first time, the Army’s suicide rate, routinely the highest among the branches of the armed services, surpassed that of the national population. By 2010, suicide had become a military crisis. That year, there were 163 suicides in the Army, an 87-percent increase from five years before.
It is a population that is especially vulnerable: Many service members return from combat with some degree of post-traumatic stress or traumatic brain injury, both of which can contribute to depression and suicidal thoughts. Easy access to guns, which prove fatal much more often than other means of attempting suicide, may exacerbate the problem.
The Army struggled to respond to the surge in suicides. [But obviously it did not struggle very hard at all, since it effectively ignores and then cancels programs that work. – LG]
Kevin Drum explains all, with his usual flair. He’s the Fred Astaire of blog posts.
Jennifer Rubin’s post in the Washington Post is a must-read, but I’ll quote just the opening (and it gets better). And I always like to point out that Ms. Rubin is a conservative Republican (but with intelligence and principles):
If you think politicians should make cogent argument for their proposals, not cherry-pick facts; recognize economic and political realities, not lie about what they and their opponents say; and own up to the defects in their own proposals, you are probably very distressed — or cannot bear to watch the day’s events.
We’ve heard all sorts of nonsense from GOP leaders and White House press secretary Sean Spicer on Tuesday:
- The Congressional Budget Office can predict the budget but not coverage numbers. (Actually, the coverage helps determine the budget numbers.)
- The president never promised to cover everybody. (He did.)
- There will be 60 votes for follow-on legislation that the GOP acknowledges is essential. (No Democrat in the Senate shows any interest whatsoever in any part of this.)
- Then-House Speaker Nancy Pelosi (D-Calif.) said you’d have to pass the bill to find out what’s in it. (She in essence said you’d have to get away from the political noise to appreciate it.)
- The Obamacare process was less transparent than the GOP’s has been. (The reverse is true. By a lot.)
- The CBO number is ridiculous — except for the parts we like. (Need we say more?)
- It’s the GOP bill or nothing. (Actually, not even Republicans agree, as we discuss below.)
The reason for the higher level of incoherence than normal is not hard to figure out. The Post reports:
The maijuana the government supplies to researches might as well be dried oregano. Read the article.