Randy Kuhl's office has announced that the Canandaigua VA Hospital will add 23 new jobs to staff a 24-hour suicide prevention hotline. As in the past, announcements about what will happen at the VA hospital have to be considered carefully against evidence of what does happen, because previous reports about that facility have been innaccurate.
On another topic, Kuhl is a co-sponsor of newly introduced legislation to allow home delivery of IV infused medication. This bill is an interesting peek into the Medicare system. According to the head of the Infectious Disease Society of America, private insurers have been paying for home infusion for years, yet Medicare recipients still must travel to a hospital or outpatient facility to have IVs administered. Private insurers were able to realize the cost savings and adjust their procedures long ago, yet it (literally) takes an act of Congress to change Medicare. This might reflect bureaucratic inflexibility, or Medicare's superior standard of care. I would guess the former, and point to this as another example of why people are leery of government-delivered health care.
Comments
It does point to inflexibility, although I wonder if a private insurer would have made the change if it benefited patients but was even slightly more costly.
More flexibility is certainly desirable, if it is cost-effective and improves service.
You're right - private insurers are no saints, either. But this example points out that the healthcare solution has to recognize and avoid the inflexibility of Medicare. I don't see a clear recognition of just how bad Medicare can be in the single-payer rhetoric.
Agreed. My point is that we can at least petition our legislators for better coverage, but that private insurers are not likely to be responsive, unless it helps their bottom line.
Both Edwards and Obama leave some room for a head-to-head competition between the single payer and the private plans. Supposedly, the market would choose the winner. I like that idea. Of course who knows how level the playing field would be after such a plan was processed in Congress.
I understand the suspicion of government's ability to run a cost-effective program of any kind, and I know that Medicare has been tarred with the Big Government brush. I know too that health providers aren't crazy about Medicare or Medicaid or the private insurers, for that matter (although private insurers can offer perks as part of their marketing and Medicare can't). Given the power of the Insurance/Pharma Lobby, I'm afraid that we will end up with privatized Medicare for all, but with with the Federal Government underwriting the most costly claims.
The taxpayers will pay for private insurance, 20% or more will go to corporate profit, and we'll also pay for the 2% of the cases that are 50% of the cost of health care in the US. That seems like a bad deal to me.
I agree that the market-based plans will live or die on the ability of Congress to construct and regulate a fair market. Current Republicans don't seem to understand the difference between fair market rhetoric and truly fair markets. We get a lot of veneration of the concept of markets, with slack implementation of the legal mechanics of markets. Oligopolies are the rule in a lot of big markets, health care being one of them.
Private insurers living by tough, well-enforced rules could be the best of all worlds, but, I agree, it's hard to see tough rules being passed given the lobbying influence in Congress.