23 July 2009

The HAL between you and your Doctor...Updated

There are many spewings from the Right WingNuts that are irritating. Among the most such is the claim that a Single Payer health system will "put the government between you and your doctor" or "some government accountant will decide what care you get". Neither is true, of course. What's more evil is that there is already someone between you and your doctor, and HMO/insurance bean counters already decide what care you will get.

I know. I wrote (not from the start or in its entirety) such software. There are a number of these packages; the one I worked on is called Optimed. The company's been sold a few times since I was there, and is now a part of MEDecision. These applications (others: Milliman, InterQual) seek to disallow services. Nothing more. They claim to improve health, but that's just not true.

So, the next Right WingNut who spews that nonsense; break his knee and tell him he won't qualify because he brought it on himself.

You can help by contacting your congress person and Obama. This is such a big lie that letting it continue is criminal.


A couple of days after I penned this, Krugman wrote on the subject, although there isn't a discussion of how insurance companies steal your coverage.

01 July 2009

Dumb, Fat, Unhappy, Poor, Old .... and Sick

By now most folks should know that the Red/South states come in last in terms of education, jobs, income, and smarts by any measure. Now, we find out what that means.

It means that not only ain't they Dumb, Fat, and Happy, they are Dumb, Fat, Poor, Old..... and Sick. While being a Keynesian is orthogonal to Social Darwinism, this story inevitably leads to some pondering. How should we spend our health care dollars? If we spend like the Europeans do, we all live longer and healthier lives. If we continue the way we are, we end up funneling most of our health care dollars into the pockets of HMO's, Big Pharma, and BioTechs. I've been spending some time looking at BioTech/Pharma, and what I see is lots of money going into the pockets of Management in pursuit of multi-kilo buck life extending drugs (broadly defined).

What seems to be the norm is that some scientist or doctor does come up with a novel entity, but aimed at a really small segment of the unwell. The aim is to get as much money into the hands of management (million dollar payments are not uncommon), typically not the founders, scientists, or doctors. Then the FDA process goes on for some years. If the entity is blessed, then the kilo-buck payments begin. Whether any of that gets to the original investors...

The BioPharma traders are scared crapless of Obama. And well they should; the gravy train may well be over. What is not remembered is that, up until the 1970's (or thereabouts), most research was done on the public dime, and the compounds thus discovered were available to all. BigPharma didn't like that, so now we have massive expenditures on trivial (from a public health point of view) drugs in the hope of getting a massive payoff. From public funds, of course; MediCare and MediCaid. For-profit health insurers won't pay for this stuff.

So, we the intelligent and healthy will be stuck paying the bill to keep these self-abusing knuckleheads alive for a few more months. Is this anyway to run a railroad?