Texas is number one in the country for people without health insurance. Fully one quarter of Texans have no health insurance at all. Another 26% are on Medicaid, Medicare or other public assistance programs that provide help to get health care, according to the Texas Medical Association. The poverty rate in Texas is also high. Twenty-one percent of adults, 17% of the elderly and 34% of Texas’ children live in poverty. Despite these dire circumstances, Texas Gov. Rick Perry is refusing an offer from the federal government to expand Medicaid, even though the feds will pick up 100% of the cost for the first three years. The reimbursement rate will drop to 90 percent after that. The offer is part of the Patient Protection and Affordable Care Act, or “Obamacare,” a slate of changes to health insurance enacted in the U.S. that Gov. Perry and some other Republican governors dislike. Last July, Perry wrote a letter to the U.S. Department of Health and Human Services last July (pdf) in which he called the offer to expand Medicaid a “gun to the head” of his state. He called the Affordable Care Act a “power grab,” and reiterated that statement in a November 18 blog post on his personal website. By refusing to accept the federal assistance to expand Medicaid, Gov. Perry is turning down $164 billion that would go to help insure the poorest Texas citizens. The assistance would also stimulate Texas’ economy. An analysis by the Center for Public Priorities, a think tank based in Austin, found that every federal dollar the state would spend on Medicaid assistance would return $1.29 in “dynamic state government revenue” over the first ten years of expansion, since Medicaid expenditures generate economic activity while creating a healthier, more productive population.
As America’s population ages, tens of millions of people find they can’t afford health insurance, medical care is getting more expensive and is difficult for many people to get. Our culture focuses on prolonging life at virtually any cost. At the same time, as fewer people want to take the option of prolonging their life at any cost, the reality that death as a natural part of life is little acknowledged or discussed. This difficult situation is leaving more people seeking gentle, accessible and painless ways to die. A new PBS Frontline documentary, “The Suicide Plan,” dares to explore the difficult subject of the growing need for people to find easy and painless ways to die. Filmmakers Miri Navasky and Karen O’Connor explore the realities of people who are actively seeking ways to die without violence or suffering. While researching and filming the program, the filmmakers say they were astounded by the number of people yearning for information on how to control the timing and manner of their own death. The filmmakers were also “completely surprised,” they say, to discover the extent of the underground organizations growing up around meeting this growing, unmet need. Navaski says, “Here — in the underground world — doctors are reluctant to prescribe lethal doses of medication, so people who want help dying are relying of imperfect, cobbled-together methods.” The documentary explores organizations like the Final Exit Network and Compassion and Choices, whose missions are to help people find ways to achieve a peaceful death. The Suicide Plan aired on Tuesday, November 13. The documentary can be viewed here.
Source: PBS.org, November 13, 2012
Mitt Romney’s former company, Bain Capital, may refuse to make public the clients it has served, but now previously-secret tobacco industry documents reveal Bain & Company worked closely with cigarette makers British American Tobacco, Philip Morris and Gallaher, to help them expand their markets and become more profitable at the expense of global public health. Bain helped British American Tobacco (BAT) crack open the cigarette market in Russia and transform it into a lucrative business at a time when American tobacco companies were under pressure at home and smoking rates in the U.S. were decreasing. By 1993, during the time when Bain worked with cigarette makers, the dangers of smoking were well established. The 1964 Surgeon General’s report had announced that cigarettes caused cancer. In 1988 the U.S. government warned that nicotine was addictive in a similar manner as heroin and cocaine. In 1989 the Surgeon General announced that most people begin smoking as children and one in every six Americans was dying from smoking. In 1993 the EPA rated secondhand tobacco smoke a Group A Human Carcinogen — the same rating the agency gives to asbestos, radon gas and vinyl chloride. Romney took over Bain in 1990 and stayed until 1995, when this crucial public health information about smoking was public. When Romney took over Bain, the company was in financial distress and seeking new clients. One of the first new clients Bain signed during that time was Philip Morris (PM). Little more than a month after Romney took over, Bain signed a six month contract with Philip Morris estimated to be worth $1 million.
Insurance companies are hot targets in the national discussion of skyrocketing medical costs and health care reform. But there is another, little-noticed factor could also be sucking untold health care dollars out of our pockets. It’s one we are also loathe to address: the part that doctors play in pushing up the costs of medical care. This is an area that is begs for closer scrutiny, and in which patients need more help.
An Examination Day Surprise
My interest in this topic was piqued by a personal experience that brought home the problem of runaway medical costs in a truly shocking way.