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Archive for July, 2009

Healthcare Reform: Which Comes First – Lives or Money?

As Congress continues to struggle with healthcare reform, I suggest that there is one way to look at it that might make the arguments simpler than they currently are.
money or people
I see only two points of view. No matter who you are or what your interest in reform is, you fall into one of these categories:

Lives First
(Then Money)


Money First
(Then Lives)

Lives First” people understand that lives are more important than money.  Not that money isn’t also important.  It’s just that they believe that aspects such as no insurance denials for pre-existing conditions, or making sure rewards are in place for innovation, or assuring access for everyone (everyone must participate) or making sure there is focus on health outcomes improvement — are more important than how reform will initially be paid for.

Money First” people understand that controlling costs and reining in spending are more important than worrying about who gets what kind of options for care or access.  They understand that yes, people die or get sicker (and more expensive) when they don’t have access, but that denying access to some means others can get better care. They tell the Lives First people that if money isn’t the first consideration, then it will mean rationing for all, as if that is something new. (A bogus argument, by the way, because rationing is already a part of our care.)

Some generalizations, although I realize there are exceptions:

The Lives First people are often people who have had their access challenged due to cost (or they have watched a friend or loved one who has desperately needed access and could not afford it.)  I’ve been there.  Although I had high deductible health insurance when I suffered my misdiagnosis, the co-pays were back breakers. I lost every penny I had in savings just trying to keep up — all for the privilege of proving the medical experts were wrong.

The Money First people are typically people who do have access, either because their employer subsidizes their health insurance or because they are already age 65 and older and have Medicare.  They see reform as something that will impinge on their income because it certainly won’t get in the way of THEIR access.  They don’t need to worry about other people’s lives.  They only need to worry about their money. (I have to wonder about the Medicare recipients who think money is more important – do they have this conversation with their children?)

Based on that description, which do you think I am?  There’s probably not much question in your mind — but this may surprise you: My husband and I have good healthcare coverage because he is retired from the Air Force and that gives us access to a government payment system for the rest of both our lives.  Healthcare reform will end up costing us more money than we pay now, there’s no doubt.  Based on my own generalizations, you might expect me to be a Money First person….

But of course, I am not.  I hear from too many of those people who don’t have access, who have bankrupted because of medical needs, who work up to four or five jobs just so they can buy into a high deductible, catastrophic plan, just like I had. They get sicker, or they lose a loved one, not because the care wasn’t available, but because they could not afford it, or because they were denied care since they had no insurance.

Don’t get me wrong.  I understand that money is an extremely important consideration in the debate. We need to be responsible about the money questions, and yes, I get the “don’t want to mortgage our children’s future” argument. I believe we need both points of view to hammer out the best approach.

But, if you are a Money First person, I ask you to consider that Lives First may be the more fiscally responsible approach.  If we build a new healthcare system that assures access, even if it’s quite expensive to begin with, then over the longer term, we will be “building” a healthier populous — one that won’t need as much of the same kind of expensive access we have today.  In the long run, the system will cost far less with healthier people who won’t have to go bankrupt just to get the care they need.

Ask yourself: What’s more important to you? And which profile is yours? I wonder if maybe you’ve even put yourself into the wrong category to begin with? Does this food for thought shift your thinking at all?


Do you have concerns about healthcare reform?  Have a rumor or concern you want clarified?  Pose it here and we’ll try to uncover the truth.

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Healthcare Reform “Senior Death Warrants” Email Should Be Put to Death Itself


As predicted, the fearmongering, half truths and out-and-out lies about healthcare reform have begun in earnest.  I received an email from a dear and respected friend yesterday and was appalled at the dis-information it contained.

So I’ve decided to share the email with you and show you where it is wrong and why you need to question anything you hear in these kinds of emails, blog posts and other pieces you may read.

The email, called SENIOR DEATH WARRANTS is printed here in its entirety.  I’ve footnoted my responses below.

The actress Natasha Richardson died after falling skiing in Canada. It
took eight hours to drive her to a hospital. If Canada had our healthcare she might be alive today.
In the United States, we have medical evacuation helicopters that would have gotten her to the hospital in 30 minutes. (untrue – see comment 1)

In England anyone over 59 cannot receive heart repairs or stents or bypass because it is not covered as being too expensive and not needed.  (untrue - see comment 2)

Obama wants to have a healthcare system just like Canada’s and England’s. (untrue - see comment 3)

I got this today and am sending it on. If Obama’s plans in other areas don’t scare you, this should! Please do not let Obama sign senior death warrants!!

Everybody that is on this mailing list is either a senior citizen, is
getting close or knows somebody that is.  (true!)

Most of you know by now that the Senate version (at least) of the “stimulus” Bill includes provisions for extensive rationing of health care for senior citizens. (untrue – see comment 4)

The author of this part of the bill, former senator and tax evader, Tom Daschle was credited today by Bloomberg (untrue - see comment 5) with the following statement:

Bloomberg: Daschle says “health-care reform will not be pain free. Seniors should be more accepting of the conditions that come with age instead of treating them.”
(untrue see comment 6)

If this does not sufficiently raise your ire, just remember that our esteemed Senators and Congressmen have their own healthcare plan that is first dollar or very low co-pay which they are guaranteed the remainder of their lives and are not subject to this new law if it passes. (true!)

Please use the power of the Internet to get this message out. Talk it up at the grassroots level.

We have an election coming up in one year and nine months, and we have the ability to address and reverse the dangerous direction the Obama administration and it allies have begun and in the interim, we can make their lives miserable. Lets do this! (see comment 7)

Comment 1: Natasha Richardson fell and hit her head, and refused to be taken by ambulance to the hospital.  No one can be treated if they don’t seek treatment.  Yes, later her husband phoned for help, but by then it was too late.  Could they have taken her by helicopter for help if she had been in the US?  Maybe — but we will never know.  This form of condemnation of Canada’s healthcare system is purely speculation.  No matter what country anyone lives in, they won’t get care if they refuse help.  News articles indicate that helicopters are available for transport in many areas in Canada, but not remote areas.  That is true in the US, too.

Comment 2: I went straight to some doctors in the UK for this answer ( I network with many doctors in England on Twitter.)  They assure me that there is no such policy.  One even asked me “is that a serious question?”

Comment 3: I have scoured the Internet and can find no where where any bona fide news organization has reported that Mr. Obama has made any such statement.  There are blogs, comments and editorials on some news websites, but no hard news anywhere that reports this statement or any statement like it.

Comment 4: The stimulus bill has nothing to do with quality of care or delivery of care.  It does contain $57 billion for development of an electronic medical records system which will eventually cut the cost of care and will improve the safety and delivery of care.  Will rationing take place?  Of course it will.  It already does.  But that has nothing to do with the stimulus bill!

Comment 5: Bloomberg has never quoted Tom Dashle saying any such thing!  I checked in with one of my favorite resources, Politifact and they spell out exactly how this rumor came to be.

Comment 6: In fact, that quote came from Betsy McCaughey in the form of a letter to the editor.  And while I have admired Dr. McCaughey’s work in hospital acquired infections for many years, I believe she is WAY off base by making such a statement.  Inflaming an already contentious argument does not help. (Update: McCaughey is truly going off the deep end, now making statements that the healthcare reform will will make it mandatory for Medicare recipients to go through required counseling to tell them how to end their lives sooner.)

Comment 7: Healthcare reform is going to happen.  We can make it easier on ourselves by dealing in the truth, and helping the cause.  Or we can make it far more difficult on everyone by fearmongering and inflaming.  Sending an email full of half-truths, lies and speculation doesn’t help!  If you truly want to get involved at the grassroots level, then I ask you to instead contact your local congress person and share your feelings about what is important to you.

Read more about the Senior Death Warrant at my About.com blog.


Do you have concerns about healthcare reform?  Have a rumor or concern you want clarified?  Pose it here and we’ll try to uncover the truth.

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