With the Congressional debate over health care reaching a crescendo, I find myself particularly baffled by the behavior of two influential Senators. Why, I wonder, would Sen. Max Baucus, a Democrat from Montana, and Sen. Charles Grassley, a Republican from Iowa, oppose a public health insurance option that could compete with private insurers? Baucus, after all, has worked closely on health-care reform with Senator Edward Kennedy, a stout supporter of a public option. And Grassley, who has taken the lead in investigating doctors on the take from pharmaceutical and medical device companies, must surely understand the corrosive influence of the for-profit motive in health care.
Grassley says he opposes a public plan for fear it would eventually put private insurance plans out of business, according to an excellent overview of the debate in The New York Review of Books. But isn't that the idea? Are we not the only developed country in the western hemisphere that permits for-profit health insurance? Why should Grassley and Baucus care so much about the fate of for-profit medicine?
Here's one reason why: both Senators have received tons of money from PACs and individuals representing the health-care industry in recent years. Indeed, the two or three top industries contributing to Grassley and Baucus's campaign chests from 2003 to 2008 are, you guessed it, insurance companies and health professionals. According to the Center for Responsive Politics, health professionals donated $812,077 to Grassley between 2003 and 2008, while insurance companies gave him a total of $643,643. Similarly, health professionals contributed $851,141 to Max Baucus over the same period of time, while insurance companies gave him $784,185. (Pharmaceutical companies, who are similarly opposed to a public health option because it will eat into their profits) also contributed $852,813 to Baucus' war chest during the same years).
And if you look at the top individual donors to these Senators, you see the same pattern: on both Grassley and Baucus's top 20 list, you will find the American Hospital Association, the American Health Care Association (which represents nursing homes), a number of health insurers, such as Blue Cross/Blue Shield and Aetna, and several organizations representing medical professionals. As I noted in a previous blog, many doctors don't want a public health option because it will eat into their profits, since Medicare and Medicaid tend to reimburse doctors (and pharmaceutical companies) at lower rates than private insurers do.
Now you can view this as just one more sad illustration of the power that moneyed interests have over our Congressional leaders. But if I were a voter in Montana or Iowa worried about paying my medical bills, I might want to pick up the phone and ask Senator Baucus or Grassley just who exactly they are representing: me or corporate America?
Monday, June 29, 2009
Friday, June 19, 2009
Most Americans support government-run health plan
We're taking advantage of the end of school to do some traveling to Philadelphia and Washington to scout out colleges for our son. And speaking of the nation's capital, it was good to see that a robust majority of Americans support a government-run health insurance plan to compete with private insurers, according to the latest poll by The New York Times and CBS. Most Americans also think government could do a better job of holding health-care costs than the private sector. Are you listening, Congress?
I will resume blogging next week.
I will resume blogging next week.
Wednesday, June 17, 2009
Freedom Center: The "mad pride" approach to mental illness needs your support
Caty Simon was 15 when she tried to kill herself by swallowing some pills. A smart, precocious student at an Orthodox Jewish day school in the Boston area, Simon says the pressures on her -- to succeed academically and fit into a culture where women were not considered equal to men -- had been building for months. What Simon needed was someone she could talk to, a shoulder to cry on. Instead, she found herself in the locked juvenile ward of a mental hospital, diagnosed as paranoid schizophrenic and bipolar and doped up with drugs like Zyprexa, Prozac and Depakote.
"The next couple of years were horribly dysfunctional for me," Simon recalls. "The Depakote made me incredibly depressed, it really knocked me out. I spent my senior year in bed."
For years, Simon says she bought into what her psychiatrists told her: that she had a lifelong, biogenetic mental illness that could only be treated with potent psychoactive drugs. But then she began reading books by Persimmon Blackridge (Prozac Highway) and Dr. Peter Breggin, author of Toxic Psychiatry, among many other books, and she eventually stopping taking the drugs. She later dropped out of college (Bryn Mawr) and moved to Northampton, Massachusetts, where she became involved in activism. (In recent years, Simon has worked on many social justice issues and was instrumental in convincing the Northampton officials to reject an ordinance that would have outlawed pan-handling in the city). But as Simon recounts in an article posted on The Icarus Project, she knew she still needed help with her "emotional extremes."
When she was 22, Simon stumbled upon the Freedom Center, a psychiatric survivor group in Northampton that had been founded a few years prior by two other former mental patients, Will Hall and Oryx Cohen. In Simon's words, "The Freedom Center is the area's only group run by and for people labeled with severe 'mental illnesses.'" The center is opposed to involuntary treatment and what it calls "forced drugging," and it supports treatment alternatives such as yoga, meditation, exercise, nutrition and access to peer-run support groups. The Freedom Center puts its money where its mouth is: offering members free yoga, acupuncture, exercise and nutrition sessions, as well as entry to its weekly support groups.
Simon has been attending the Freedom Center's support groups on and off for the last six years and helping to spread the word about its mission.
"One can't say enough about what a difference it makes to work through one's problems among peers rather than trying to solve them within a hierarchial model," she writes in her Icarus Project article. "In our support groups, we try to help people make their own decisions based no their own values rather than judging them according to an APA approved notion of what is 'adjusted,' 'functional,' and 'mentally healthy.'
Simon is quick to point out that the Freedom Center is not anti-drugs. "We fully support people if they are firm believers in the biochemical model of mental illness, if that's the model that helps them live the lives they want to lead," she says. "By acknowledging that people are experts when it comes to their own selves, we create an environment in which people are best able to help themselves progress toward recovery."
In her book, Agnes's Jacket, psychology professor Gail Hornstein devotes an entire chapter to the Freedom Center, citing it as one of the most successful models in this country of what she terms the psychiatric survivor movement. And Newsweek recently wrote about the center's involvement in the growing "mad pride" movement.
The Freedom Center, however, is currently in financial straits, a fact that Caty Simon finds sadly ironic. "Just as we're getting so much press, we're really struggling financially to keep our core services alive," she says. To raise awareness about the center, Simon and other members of the center are organizing a speakout later this summer at which psychiatric survivors will get together and tell their stories. "There's something really empowering about people telling their stories, for example, about being mistreated and force medicated," she says. "This spoken presentation is amazingly powerful."
In the meantime, if you want to learn more about the Freedom Center and make a donation, just click here. Your support could help someone else find the inner strength and stability that Caty Simon has.
"The next couple of years were horribly dysfunctional for me," Simon recalls. "The Depakote made me incredibly depressed, it really knocked me out. I spent my senior year in bed."
For years, Simon says she bought into what her psychiatrists told her: that she had a lifelong, biogenetic mental illness that could only be treated with potent psychoactive drugs. But then she began reading books by Persimmon Blackridge (Prozac Highway) and Dr. Peter Breggin, author of Toxic Psychiatry, among many other books, and she eventually stopping taking the drugs. She later dropped out of college (Bryn Mawr) and moved to Northampton, Massachusetts, where she became involved in activism. (In recent years, Simon has worked on many social justice issues and was instrumental in convincing the Northampton officials to reject an ordinance that would have outlawed pan-handling in the city). But as Simon recounts in an article posted on The Icarus Project, she knew she still needed help with her "emotional extremes."
When she was 22, Simon stumbled upon the Freedom Center, a psychiatric survivor group in Northampton that had been founded a few years prior by two other former mental patients, Will Hall and Oryx Cohen. In Simon's words, "The Freedom Center is the area's only group run by and for people labeled with severe 'mental illnesses.'" The center is opposed to involuntary treatment and what it calls "forced drugging," and it supports treatment alternatives such as yoga, meditation, exercise, nutrition and access to peer-run support groups. The Freedom Center puts its money where its mouth is: offering members free yoga, acupuncture, exercise and nutrition sessions, as well as entry to its weekly support groups.
Simon has been attending the Freedom Center's support groups on and off for the last six years and helping to spread the word about its mission.
"One can't say enough about what a difference it makes to work through one's problems among peers rather than trying to solve them within a hierarchial model," she writes in her Icarus Project article. "In our support groups, we try to help people make their own decisions based no their own values rather than judging them according to an APA approved notion of what is 'adjusted,' 'functional,' and 'mentally healthy.'
Simon is quick to point out that the Freedom Center is not anti-drugs. "We fully support people if they are firm believers in the biochemical model of mental illness, if that's the model that helps them live the lives they want to lead," she says. "By acknowledging that people are experts when it comes to their own selves, we create an environment in which people are best able to help themselves progress toward recovery."
In her book, Agnes's Jacket, psychology professor Gail Hornstein devotes an entire chapter to the Freedom Center, citing it as one of the most successful models in this country of what she terms the psychiatric survivor movement. And Newsweek recently wrote about the center's involvement in the growing "mad pride" movement.
The Freedom Center, however, is currently in financial straits, a fact that Caty Simon finds sadly ironic. "Just as we're getting so much press, we're really struggling financially to keep our core services alive," she says. To raise awareness about the center, Simon and other members of the center are organizing a speakout later this summer at which psychiatric survivors will get together and tell their stories. "There's something really empowering about people telling their stories, for example, about being mistreated and force medicated," she says. "This spoken presentation is amazingly powerful."
In the meantime, if you want to learn more about the Freedom Center and make a donation, just click here. Your support could help someone else find the inner strength and stability that Caty Simon has.
Thursday, June 11, 2009
More doctors disagreeing with AMA over universal health care
As Congress steps up its efforts to craft a comprehensive health care reform bill, Senator Edward Kennedy (in absentia) is leading the charge for a public health insurance option that can compete with private insurers. As far as I can tell, this would not only involve the expansion of Medicaid to cover people who are currently uninsured and earning below a certain income, but it would also offer a cost-based health plan administered by the government or a nonprofit cooperative (the details haven't been worked out yet) to folks who have had it up to here with private for-profit health plans.
The Republications, of course, are screaming socialized medicine. And rushing to their side is the powerful doctors group, the American Medical Association. According to The New York Times today, the AMA opposes the creation of a government-sponsored insurance plan, claiming it will restrict patient choice by eventually driving out private insurers.
What the AMA is really concerned about are profits -- a public health plan, much as Medicare and Medicaid now do, would reimburse doctors for tests and treatment at a lower rate than private insurers and that would threaten many doctors' six and seven-figure salaries. God forbid!
Fortunately, as Robert Pear in theTimes article and Doug Bremner's blog notes, the AMA no longer speaks for many doctors. Indeed, there is a large group, the Physicians for a National Health Program, which supports a single-payer system of insurance, in which a single public entity would pay for health services but most care would still be delivered by private doctors and hospitals. As Pear notes, many doctors have become so fed up with the administrative hassles of private insurance that they are looking for alternatives.
In an op-ed piece in The Boston Globe earlier this week, Dr.Steven Bergman, a psychiatrist and author of The House of God, expressed these sentiments with particular eloquence. Under a universal, government-run health care system, Bergman says, doctors would no longer "have to spend an evening filling out dozens of different insurance forms -- and then submit them a month later when they are denied or reduced."
What Bergman doesn't mention is how fed up many consumers (who don't have a powerful lobbying group like the AMA to give them voice) have become with for-profit health plans that charge them high premiums and then don't really cover them when they need care. I wrote about the millions of Americans who are grappling with unaffordable medical bills as a result of such deliberate under-insurance for The Boston Globe last year. This problem has only become more acute, as health insurers seek to hold onto their excessive profits,
As Bergman points out, the administrative cost for a private, for profit health insurance system is approximately 33 percent ($300 billion annually), while the administrative cost for the the two government-run health systems, the VA and Medicare, is about 3 percent. Yet "the level of satisfaction with these two nonprofit systems is high; that of the for-profit is low," he notes.
Bergman then asks the pertinent question: Why in the world should health care be for profit? Why indeed. The U.S. is currently the only developed nation in the western world that allows for-profit health systems. Yet despite all the evidence in favor of public health insurance, Bergman is concerned that Congress will fold before the combined juggernaut of for-profit health insurers and powerful doctors trying to protect their profits. If that happens, and there is a strong likelihood it will, Bergman calls on doctors and other health care professionals to go on a nationwide strike. Hear hear!
So what can you, the consumer, do? Call your Congressional representative and tell them that you want a public health plan option as part of the current overhaul. And then call your doctor and make sure he or she is ready to man the balustrades.
The Republications, of course, are screaming socialized medicine. And rushing to their side is the powerful doctors group, the American Medical Association. According to The New York Times today, the AMA opposes the creation of a government-sponsored insurance plan, claiming it will restrict patient choice by eventually driving out private insurers.
What the AMA is really concerned about are profits -- a public health plan, much as Medicare and Medicaid now do, would reimburse doctors for tests and treatment at a lower rate than private insurers and that would threaten many doctors' six and seven-figure salaries. God forbid!
Fortunately, as Robert Pear in theTimes article and Doug Bremner's blog notes, the AMA no longer speaks for many doctors. Indeed, there is a large group, the Physicians for a National Health Program, which supports a single-payer system of insurance, in which a single public entity would pay for health services but most care would still be delivered by private doctors and hospitals. As Pear notes, many doctors have become so fed up with the administrative hassles of private insurance that they are looking for alternatives.
In an op-ed piece in The Boston Globe earlier this week, Dr.Steven Bergman, a psychiatrist and author of The House of God, expressed these sentiments with particular eloquence. Under a universal, government-run health care system, Bergman says, doctors would no longer "have to spend an evening filling out dozens of different insurance forms -- and then submit them a month later when they are denied or reduced."
What Bergman doesn't mention is how fed up many consumers (who don't have a powerful lobbying group like the AMA to give them voice) have become with for-profit health plans that charge them high premiums and then don't really cover them when they need care. I wrote about the millions of Americans who are grappling with unaffordable medical bills as a result of such deliberate under-insurance for The Boston Globe last year. This problem has only become more acute, as health insurers seek to hold onto their excessive profits,
As Bergman points out, the administrative cost for a private, for profit health insurance system is approximately 33 percent ($300 billion annually), while the administrative cost for the the two government-run health systems, the VA and Medicare, is about 3 percent. Yet "the level of satisfaction with these two nonprofit systems is high; that of the for-profit is low," he notes.
Bergman then asks the pertinent question: Why in the world should health care be for profit? Why indeed. The U.S. is currently the only developed nation in the western world that allows for-profit health systems. Yet despite all the evidence in favor of public health insurance, Bergman is concerned that Congress will fold before the combined juggernaut of for-profit health insurers and powerful doctors trying to protect their profits. If that happens, and there is a strong likelihood it will, Bergman calls on doctors and other health care professionals to go on a nationwide strike. Hear hear!
So what can you, the consumer, do? Call your Congressional representative and tell them that you want a public health plan option as part of the current overhaul. And then call your doctor and make sure he or she is ready to man the balustrades.
Monday, June 1, 2009
The fish rots from the head: conflicts of interest at Partners and Harvard Medical School
Much has been written about prominent doctors who fail to disclose their lucrative financial ties with pharmaceutical and medical device companies. Yet there has been less focus on hospitals and other leading institutions who have similar conflicts of interest -- until now. In The Boston Globe Sunday, long-time investigative reporter Steve Kurkjian turns the spotlight on the enmeshed relationships between the long-time chairman of Partners, New England largest health-care company, and the pharmaceutical industry.
Kurkjian's eye-opening account reveals that Partners failed to disclose that its long-time chairman, Jack Connors, has owned several lucrative businesses that profited from their close ties both to Partners' teaching hospitals and Harvard Medical School, which provides the faculty and residents that staff Partners hospitals. One of Connors' businesses was a company that received millions of dollars in funding from pharmaceutical companies to provide continuing medical education to doctors affiliated with both Partners and Harvard Medical School. Indeed, as Kurkjian notes, Connors' company, M/C Communications, "profited hugely from an exclusive commercial relationship it maintained with Harvard Medical School." But Partners didn't think it important to disclose that enormous conflict of interest to its own board or the public. Nor did Partners disclose the fact that Connors (after he sold M/C Communications in 2004 for a whopping $450 million) founded another for-profit home-care company that has solicited business from Partners hospitals. If that's not a conflict, I don't know what it is.
Connors, as this fawning 2007 article in The Boston Globe magazine shows, has long been one of Boston's best-connected and wealthiest power brokers. As the founder, long-time executive and now chairman emeritus of Hill Holiday Connors, Cosmopolos, (Partners' advertising firm, by the way) Connors has been at the epicenter of many a lucrative business and political deal in our fair city. For example, back in the '90s, Connors helped engineer a smear campaign against Lois Pines, then running for attorney general against Thomas Reilly. Remember him? {He crashed and burned running for governor of Massachusetts).
A few years back, Connors was even floated as a possible purchaser of The Boston Globe, along with Jack Welch and Mike Barnicle, who was fired by the newspaper for plagiarizing and making stuff up. Can you imagine these three as owners of Boston's paper of record? Perish the thought!
In this case, Connors' undisclosed conflicts of interest are emblematic of the larger flaws that exist in health care today. The kind of profitable and conflicted relationships that he symbolizes go a long way toward explaining why both Partners (which owns Mass. General Hospital) and Harvard Medical School have been so loathe to strengthen their own conflict of interest policies and take action against compromised doctors like Joseph Biederman (a big gun at MGH), despite pressure from students and some faculty. After all, if Partners' own chairman is allowed to get away with undisclosed conflicts of interest, how honest can the folks at the helm of either institution be? Who was it that said the fish rots from the head?
Kurkjian's eye-opening account reveals that Partners failed to disclose that its long-time chairman, Jack Connors, has owned several lucrative businesses that profited from their close ties both to Partners' teaching hospitals and Harvard Medical School, which provides the faculty and residents that staff Partners hospitals. One of Connors' businesses was a company that received millions of dollars in funding from pharmaceutical companies to provide continuing medical education to doctors affiliated with both Partners and Harvard Medical School. Indeed, as Kurkjian notes, Connors' company, M/C Communications, "profited hugely from an exclusive commercial relationship it maintained with Harvard Medical School." But Partners didn't think it important to disclose that enormous conflict of interest to its own board or the public. Nor did Partners disclose the fact that Connors (after he sold M/C Communications in 2004 for a whopping $450 million) founded another for-profit home-care company that has solicited business from Partners hospitals. If that's not a conflict, I don't know what it is.
Connors, as this fawning 2007 article in The Boston Globe magazine shows, has long been one of Boston's best-connected and wealthiest power brokers. As the founder, long-time executive and now chairman emeritus of Hill Holiday Connors, Cosmopolos, (Partners' advertising firm, by the way) Connors has been at the epicenter of many a lucrative business and political deal in our fair city. For example, back in the '90s, Connors helped engineer a smear campaign against Lois Pines, then running for attorney general against Thomas Reilly. Remember him? {He crashed and burned running for governor of Massachusetts).
A few years back, Connors was even floated as a possible purchaser of The Boston Globe, along with Jack Welch and Mike Barnicle, who was fired by the newspaper for plagiarizing and making stuff up. Can you imagine these three as owners of Boston's paper of record? Perish the thought!
In this case, Connors' undisclosed conflicts of interest are emblematic of the larger flaws that exist in health care today. The kind of profitable and conflicted relationships that he symbolizes go a long way toward explaining why both Partners (which owns Mass. General Hospital) and Harvard Medical School have been so loathe to strengthen their own conflict of interest policies and take action against compromised doctors like Joseph Biederman (a big gun at MGH), despite pressure from students and some faculty. After all, if Partners' own chairman is allowed to get away with undisclosed conflicts of interest, how honest can the folks at the helm of either institution be? Who was it that said the fish rots from the head?
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