Hoosiers Debate Healthcare

Healthcare Reform in the United States: Somethings Missing Up Until Now

2008-04-27T14:35:00.001-07:00

by Alex

I read an interesting article from the journal Comparative Politics today. The article, entitled "Parting at the Crossroads: The Development of Health Insurance in Canada and the United States, 1940-1965", dissected the development of our current healthcare system between said years. These 15 years were crucial in the founding of healthcare in the United States and Canada. Antonia Maioni, the author, writes about some interesting facts and findings. The most striking difference I noticed was this: When the proposal for some type of national health insurance was proposed in Canada, there had already been an experiment of the sort in one of the provinces. In Saskatchewan, as Maioni mentions,

"A medical program that combined private fee-for-service delivery with public administration and financing was introduced in 1961..."

In the United States on the other hand had no Saskatchewan, as Maioni concludes,

"The Saskatchewan experiments established the principles of universal health insurance, tested the limits of reform opponents, and ultimately demonstrated the success and shortcomings of such programs...In the United States there were few state-level initiatives in health insurance..."

This finding was still relevant until very recently. States have recently began to take the initiative in the road to universal coverage. Massachusetts's reform is right now the most provincial experiment so far, but many other states are trying to do the same. Now the only problem for states in experimenting is getting around the Employee Retirement Income Security Act or ERISA, which

"shields businesses from state and local regulation of the benefits they offer workers, including health insurance. Without the law, national companies in particular could achieve little uniformity in their benefit plans."

You can find an explanation of the ERISA problem here.

Intersesting Facts from "Sick Around the World"

2008-04-26T17:20:00.000-07:00

by Alex

Today I watched PBS Frontline's documentary on healthcare entitled "Sick Around the World." In it, correspondent T.R. Reid travels around the world to five different countries to examine their healthcare system. I took extensive notes and I figured I would share the most interesting fact I wrote down from each country. I also did some investigative journalism to give you a little bit more. So here we go...

1. In the United Kingdom, citizens and the newspapers alike rail against the National Health Service. Of all the countries Reid examined, citizens in the U.K. are the least satisfied. Now let me get more detailed, even though they have problems, the numbers still show that about 77 percent of citizens are "satisfied" with the NHS coverage. You can read more about patient satisfaction in the U.K., here in an article by Nigel Hawkes of The Times in London.

2. In Japan, 80% of hospitals and nearly all practices are private (which is more than in the United States.)

3. In Germany, Insurers, or "sickness funds", are not allowed to take a profit. Wouldn't this stiffle competition? Actually, it is quite the opposite. Instead, the insurers get paid more for insuring more people. Sickness funds negotiate prices of treatments on a schedule with medical providers, this cuts their cost of administration down.

4. In Taiwan, everybody gets a "smartcard", that is a card that has your medical records on them. They are simply swiped into the computer and all patient's records come up. This lowers administrative costs, provides for full information assimilation, and makes sure their are no overlaps in services.

5. In Switzerland, "LAMal", the name of their health system was actually voted on by the citizens. In 1994, the same year healthcare reform was being proposed in the United States, the Swiss went to the polls and barely passed the measure to move to a "single-payer" style system. Even though the measure barely passed, that is it was nearly 50/50, over a decade since its inception citizens are pretty happy with what they got.

If you want to learn anymore, you will just have to watch the film.

Addressing Income Elasticity Problems Caused By Basic Coverage

2008-04-18T22:07:00.000-07:00

by Alex

In most healthcare systems that cover a basic benefit there are of course those treatments or services which are simply too expensive for average citizens to afford. When allocating services in these countries, certain questions must be answered. As Greg Mankiw explained on his blog,

"But does that mean those of above-average income should be excluded as well? Should they lose basic benefits if they choose to pay for these marginal services with their own money?"

Moreover, Mankiw explains what the United States might have to address shortly,

"Achieving both efficiency and equality in the provision of these goods [the treatments or services]is impossible. Dealing with this conflict will provide a major challenge to the political system in the years to come."

If you were at all interested, Greg Mankiw is an economist at Harvard University. You might have used his Economics 101 book in college.

Healthcare Links!!!

2008-04-18T21:30:00.000-07:00

by Alex

Here is a primer article on "speciality" drugs from the New York Times. These expensive yet priceless drugs are in the middle of a growing market. Costs are increasing and more benefit managers (those companies that help negotiate drug prices for employer-plans) are getting into the business. Also, there might be a conflict of interest.

The New York Times reports that an article will be published, explaining Merck's involvement in writing research reports in-house and then getting physicians to put there name under the title. Over the course of this semester, one of the main topics I have been studying is the pharmaceutical industry. I read earlier this year, on the blog Freakonomics, in a quorum with healthcare experts the same thing this article will highlight. You can read Dr. Harlan Krumholz, professor of medicine, epidemiology, and public health at Yale, take on the same practice and others here.

The Wall Street Journal reports that the Massachusetts's General Court (their state legislature) is proposing to ban doctors from taking gifts from pharmaceutical industries. This is an interesting article, because it brings up a relatively new issue to hit the healthcare limelight. The issue is the relationship between doctors and pharmaceuticals. I read an article from the New England Journal of Medicine earlier this year which reported that 94% of physicians have some relationship with the pharmaceuticals. It could be free bagels or drug samples.

Final Shoot...Maybe???

2008-04-18T18:16:00.001-07:00

by Alex

Today I hitched a ride with the telecommunication students on their final shot. We went to Ball State's Amelia Wood Health Center to film the introduction of our film. In the introduction, Laura
briefs the audience on what is to come.

The shot went well, even though Laura took like 25 takes. No...she actually did a really good job. It made it a little harder for her to
speak because she was walking towards the camera at the same time.

It's "crunch-time"!!! Only 12 days till the showcase at Cornerstone.

Healthcare Links!!!

2008-04-14T19:43:00.000-07:00

by Alex

The Institute of Medicine published a report today saying that a health worker shortage is looming. You can read an article about the report here.

An op-ed piece in the Wall Street Journal by Jonathan Kellerman suggests that it would be better if fewer people were insured. Check out his rationale. I find it very interesting. He certainly makes a good argument.

An interesting piece also in the Wall Street Journal talks about the trend towards arbitration in nursing home disputes. Nursing
homes are having more and more patients sign waivers saying
they will not sue and instead arbitrate in case problems insue. Is
this right? Arbitration professionals think it is taking advantage
of people. Check it out.

"Confinement"

2008-04-14T19:24:00.000-07:00

by Alex

Confinement - a 3-syllable word meaning to be held within a location. Thanks to my roommate, I learned this word is actually
quite controversially. Here is an example where this word would
be used. In insurance plans that you and I buy, there would likely
be a part of the policy which talks about hospital confinement up
to a certain stoploss. The word confinement is used by insurance
companies because it is usually breezed over. There is no real
ambiguity about the word and therefore if theyare taken to suit
they would be safe. The problem is that sometimes people skip
over the word.

I am not taking a stand on the use of this word, but I just wanted
to give you a heads up. Those sneaky businessmen!!!

Capping Costs

2008-04-04T21:07:00.000-07:00

by Alex

Sen. Hilary Clinton just explained an idea of capping healthcare costs. While the idea is not new, she roughly explained what the cap would be at. She would want it at 5-10 percent of household income. Therefore, no family or single person would have to pay over that threshold in healthcare costs per year. Sen. Barack Obama has also mentioned this but has not specificed his proposal yet. Sen. John McCain has not announced this idea so far.

I thought this is one of the more interesting cost-cutting mechanisms I have seen. I would think Sen. Obama's plan would be similar. However, there could be disagreement in whether the cap should be progressive or flat. That is, should the rate increase as income increases, or should it be one rate for everybody.

An Update

2008-04-02T07:33:00.001-07:00

by James

We haven't been posting much in the way of new information, but that is due to how busy we all are. Currently, we're organizing displays and trying to figure out what we want printed up for the Showcase. The film editing is going well, though it seems that the length has been trimmed down, which is a bit of a shame, considering the immense amount of topic matter within the realm of healthcare. But that's life, and we will adjust. Stay tuned for more...

The Last Early Morning Interview

2008-03-26T07:17:00.000-07:00

by Laura

It’s 6:30 a.m. and I’m driving to the Center, yawning with the moon on my right, thankful that this is our last early morning shoot. I walk in the front door; blanket, pillow, and release forms in hand. We load the van and drive to Indianapolis to visit with the local hospital. Today’s goal: gather medical cover video for the film. Throughout the day we meet doctors, nurses, and EMTs who explain the outrageous amount of paper work they complete each day and show us the back rooms filled with pharmaceutical drugs. Each corner had its own story and reaction from the crew. This was one of the most memorable experiences throughout the filming process.

Assembly Trials and Triumphs

2008-03-23T21:21:00.000-07:00

by Rachel

It’s been exactly one week since our assembly and I’m still in awe that we actually pulled it off, and pulled it off well! Leaving for spring break we only had about 13 RSVPs and, as my airplane took off, I wondered if it was such a good idea that I was leaving.

The day of the assembly was absolutely chaotic. We had to wake up far too early for someone who had been sleeping in every day until 11 for the past week. Samantha, Kristen and I met early at the house to do a couple of last minute things and make sure that everything was in order. Once we were at Minnetrista it was just go, go, go! Registration was supposed to go from 12:30-1:00, but people started showing up at noon and came until after 1:00pm. One of our panelists was late, but I was too stressed about making sure people were being checked in properly that I couldn’t even worry about that. Once we finally closed shopped at the registration tables we had 37 participants in total. I couldn’t believe it; we were actually pulling this off and it was going well! Actually, it was going even better than I expected!

Unfortunately, I had to spend most of my time manning the doors and running here and there to make sure everything and everyone was where they were supposed to be. The little that I heard of the panelists speak and the questions asked were pretty good. I think the most interesting part, by far, was during the break out sessions for the small groups. We had placed tables in the lobby for the panelists, and they ended up getting into a debate about healthcare themselves! Luckily, Jordan happened to be walking by and heard what was going on so he grabbed a camera and filmed away. I’m so glad we got that on film and I think it will be such a great touch to our documentary!

I am so proud of everyone in our class for doing such an amazing job. I think Kristen, Samantha, and I really learned a lot about what it takes to plan such an event, and the rest of our class did an awesome job helping us pull off everything, especially the small group discussions, which weren’t always the easiest to get through. The fact that it took WIPB months and months to plan and hold their deliberative democracy assembly and we did it in just a little over two months makes it even better. It took a lot of long hours, not to mention stress, but we did it and our hard work definitely paid off!

Laura's Reaction

2008-03-23T19:51:00.000-07:00

by Laura

Hello, I'm Laura one of the Telecommunication students. I'm sorry I haven't written to you lately; I've been conducting various interviews and have been caught up in TCOM land. Let's get right to it, shall we? This semester has been... well I can't quite find a word to describe it, which is a big deal for a girl who's job it is to make conversation. You see, I'm the host, writer, and producer for the film. I have been involved in telecommunication since I was little, and I have never found an outlet in the academic environment that has allowed me to accomplish everything I have ever wanted to do professionally in one experience. So you see, I without a doubt can say I very much enjoy the experiences here at the Virgina Ball Center. There have been however, shall we say, hiccups. Like that one time we were rookies and traveled to Indianapolis for the first time and forgot camera batteries, a lighting kit, and other miscellaneous items --all of importance -- naturally. Not the best feeling when you have a doctor staring at you asking what you'd like to do. Or this past week when we had our assembly. Our classmates have been working on this one day for months (no exaggerations) and a light breaks, a microphone breaks, batteries are left behind, and we don't bring enough tapes. That was a fun problem solving activity. So you can see this has been quite and experience.

We have met so many memorable people along the way. Everyone from senators, state representatives, doctors, pharmaceutical representatives, and yes, the average Joes. Each with their own story. Each with their own viewpoint, own agendas. But each joining together to solve, what some have told me, is a crisis in the United States today.

Stay tuned, I'll let you know the ins and outs of the film, some of my favorite moments, and the little secrets behind the doors to the TCOM editing suite.

Remarks - Derek Sheridan's Sh'peel

2008-03-20T09:51:00.000-07:00

by Alex and Zach

Derek is a political science major and an economics minor. His friends call him Derek-Rock. He likes long walks on beaches and puppies. Sorry ladies, he is married. Enjoy!

Update to Attendance Factors: The Weather

2008-03-16T18:36:00.000-07:00

by Alex

The assembly went well and the weather was not that bad really! From data obtained on the Weather Channel website, the high was actually 43 during the day. For a weather forecast, it was pretty much on the money.

P.S. Thanks weather-gods for the event-permitting weather!!!

Attendence Factors: The Weather

2008-03-07T00:11:00.000-08:00

by Alex

So one of the big factors when having any event is the weather. Therefore, I looked at the 10 day forecast for Muncie on March 16th. Well, not great news per se.

At this time (meteorology is really just playing probability and making estimates), the forecast calls for a few snow showers. The high is predicted at 41
and low at 33.

Let us see how accurate the forecast is in a week!

T-Minus 9 Days

2008-03-06T17:24:00.000-08:00

by Alex

We have 9 days until the Hoosiers Debate Healthcare assembly. Today was really the last day to finalize everything. A few of us will be at the Center some tomorrow, but for the most part our work is done until March 16th. We are pretty anxious about the whole thing. Is it going to turn out like we have planned? Hopefully. If not...o well. We have done the best we can. This is the first time any of us have ever set up anything like this before. Moreover, it is not just an event. It is a deliberative democracy event. Therefore, there are constraints and things we cannot do. Many of the things we could do to make the event better are restricted. So I feel like all we can do now is what and see what happens. I am really happy with what has happened so far. The good thing is that if the assembly does not come out like we have hoped, the interviews and film we have is definetly enough to make a documentary in itself.

See you all in 9 days!

Vacation

2008-03-06T07:44:00.000-08:00

by James

Next week is our scheduled Spring Break, and while most students will be in a relaxation state of mind (myself included), there are members of our group who will be still hard at work, editing film and making progress on the project. We're gearing up for our Assembly, which takes place next weekend. Things are falling into place, and hopefully the bumps in the road will be minimal.

We're starting call-backs for potential Assembly participants today, as well. The current count is 14 RSVPs so far, but we are keeping our fingers crossed to increase that count. Wish us luck!

Expanding My English Vocabulary

2008-02-29T07:34:00.001-08:00

by Derek

After nearly thirty hours of telephone polling, my vocabulary has expanded. Never before was I aware that so many different words and phrases were acceptable ways of saying, "No sir, I am not interested in taking your poll today, but have a good day." The following are examples of such phrases:

"Whaaaaaat... I can't hear you!" (click).

"Not interested" (click).

"I'm busy" (click).

"I was just walking out the door" (click).

"Take me off your (expletive) list" (click).

"Now's not a good time.... actually no time is a good time" (click)

"I'm on a fixed income" (click).

"I don't know anything about healthcare" (click).

"I'm kind of dumb... I can't answer your questions" (click).

"BLANSFHELSISH (nonesense yelling into the phone)" (click).

It Is Done!!!

2008-02-27T11:49:00.000-08:00

by Alex

Yeah, we just finished polling last night. I am really excited to see the results. Here is what I know so far. We had about 540 respondents (plus or minus 2) and the female to male ratio was 60 to 40. All in all, I am pretty happy with what we accomplished.

When I know more, I will let you know!

Our Site is Live!

2008-02-26T08:56:00.000-08:00

by James

Our website is now up and ready for all to see! Please check it out at:

http://www.bsu.edu/hoosiersdebatehealthcare

It will be updated as the semester progresses, so please keep checking back.

Yes, I'm from Ball State and I'm Looking for Men 18 and Over... to Take a Survey

2008-02-26T07:59:00.000-08:00

by Samantha

One of our goals is to increase our male-to-female ratio, a noble goal if you will. In order to accomplish this goal we must only survey men because we already know women are more likely to answer the phone and complete the survey. This makes getting to the men even harder than normal. Once you have a participant on the phone, you can try your best to captivate them and reel them in to take the survey. However, asking to speak to men means explaining why you don't want to hear what the woman has to say about healthcare. Here's how some of it went for me:

Sometimes they act as secretaries...
One female said, "Honey, are you available?" and I heard a man reply, "No, I'm not available," and she politely relayed the message to me. Maybe they will say, "No, I don't think he would want to do that."
What the heck, lady? I'm not his mother-in-law. It's a five-minute poll with no wrong answers!

Sometimes there are no men in the household. "I don't have a man and I don't want a man."
How can you not laugh at such a simple blatant truth?

Sometimes the problem is just the opposite. "All I have around here are a bunch of men!"
I've heard of worse problems.

Did You Feel Embarrassed To Ask For Males To Take A Survey?

2008-02-25T21:25:00.000-08:00

by Rob

When Dan gave us the option of either doing the polls ourselves or hire a guy to have a computer do it, I felt it would be cheaper (nothing if I remember correctly) and a better experience for us to do it by ourselves. I got to admit when I came in on that first Friday, I felt nervous that I found myself doing one number every five minutes.

When ever a telemarketer or a poll person called, my parents would say, “No and don’t call back here again.” Then they turned to me and said, “They just want to sell stuff.” Then I realized I was in their position and now I figured out what it was like to be politely refused, hung up on, hearing I don’t want nothing from Ball State in the background, or to call back later and then the answering machine comes up.

Recently I got two surveys in my email, one for a blood drive and another for something else. I usually delete them, but this time I just couldn’t. They needed to know something and I must help them. So I answered their questions and submitted them.

When I completed a survey with someone, it was a wonderful feeling that you can just jump up and down with success. Sometimes in order to get through a folder, I would reward myself with a five minute break in the break room in order to keep going.

I won’t forget the last few days of doing the survey. I came in and Rachel said we were only polling males. MALES! How the hell do you ask the person on the other end to get a male to do it especially if there isn’t one there!

So next time a telemarketer calls or survey person calls, ask what it is for and if you don’t want to do it, politely tell them no thank you and then hang up. Don’t hang up or say call back later and not answer.

Now if you excuse me, I am now going to listen to the Very Best of Jethro Tull cd. Why am I in the mood for bagels and soft drinks? Why do I have the urge not to pick up my phone anymore?

Remarks - Rachel's Sh'peel

2008-02-25T09:06:00.000-08:00

by Alex and Zach

Rachel is a junior political science from Kings Island, Ohio. It is not actually Kings Island, but she lives right by it. She is in charge of Students for Obama here at Ball State. In her free-time, she admires Barack Obama. Moreover, she is currently going to see Barack give a speech in Ohio. Enjoy!

Update: She meet Barack at Wright State yesterday. She was shaking she was so excited!

Rachel's Thoughts on Polling

2008-02-23T17:26:00.000-08:00

by Rachel

So I’m sitting here in Dan’s office going through the numbers on what should [hopefully] be our second to last day of polling. Having worked for the BSU Phone-a-thon I knew this wasn’t going to be an easy task, but I was shocked that we burned through 1800 phone numbers in less than 6 days and weren’t even half way to our goal of 600 completed surveys! I’m beginning to wonder how accurate other polls are that I read about, now that I know how hard it is just to get one completed, especially by a male! I also wonder how different this experience would have been ten years ago, when hardly anyone had a cell phone or caller ID.

Although I haven’t been on the phone too much, it’s been really interesting hearing what people have to say. Almost everyone I’ve talked to has said that the number of uninsured Americans and the cost of insurance are the top two problems with America’s health care system. Also, most people have correctly answered the question about how many Americans are uninsured, though that is the middle number of the three choices, so people maybe just feel like that’s a safe bet. I hope that people will be as animated and passionate when it comes to the assembly.

Speaking of interesting, oh man, the people of Delaware county can be very entertaining! I got one answering machine where it took me a second or two to determine whether it was a machine or not, and this woman was basically saying if she didn’t call you back by Monday it was because she was on her deathbed in the hospital. I also got an answering machine where the whole family sang their last name in 4-part harmony. Creative, huh? It’s also fun to call Ball State professor’s who are always like, “Uh, do you realize you’re calling a Ball State office?” Luckily they are always really nice about completing the survey!

Tomorrow should be interesting because our polling consultants Josh and Don have decided we need to get our number of male respondents up. In order to accomplish this, tomorrow we will be asking for men only and, to be honest, this worries me. We all know for a fact our number of completed surveys will be lower, but I’m most worried about what it is going to do to everyone’s morale. We’ve discovered men are much more likely to hang up. They’re also fond of handing the phone over to their wife. Geeze men! What’s the deal?? Is it really that big of a hassle to talk on the phone for ten minutes? You don’t even have to come up with a conversation for goodness sakes!

Well, I need to get back to tallying numbers. Hopefully it’ll be good news!! Oh, and the next time someone calls asking you to complete a survey? Unless you’re walking out the door, just do it!!!

Healthcare Links!!!

2008-02-22T20:25:00.000-08:00

by Alex

Robert Reich wrote a great piece in the Wall Street Journal a little while ago about the debate over the mandate. He is referring to the ongoing debate between Sen. Clinton and Obama. Should people be mandated to have health insurance under their plans? Reich argues that it really only comes down to 3% of the population. Check it out here.

A Reuturs article writes about the still present racial disparity in treatment of black Americans. Check it out here.

If you are at all interested in spending and its relationship to life expectancy in healthcare systems, you really need to check this out. Very clean, straight up graph from the blog The Big Picture. Look who the outlier is here.

Daniel Engber on Slate argues that the cost related to obesity are really blown out of proportion. There is a debate going on about how much we spend in treating obesity. Engber says that it really isn't that much comparatively. Check it out here.

Keep warm and surf the world-wide web a bit!

Polling Update

2008-02-22T20:11:00.000-08:00

by Alex

Its Friday night and polling ended about two hours ago. We worked from 5 to 9 today and had about 7-8 phones going at over that time. I believe the final tally for the night was 66. That puts us 10 short of 400, or almost two-thirds of the way done.

We continue polling tomorrow morning at 11. This session will conclude at 7. With so many hours, I feel as if we can get to 500 by tomorrow. 600 is the number. While we are taking a little longer than expected, we feel pretty good getting there. Now, when that will be is anyways guess.

Derek's Reaction

2008-02-22T07:42:00.000-08:00

by Derek

It's amazing how much we're learning about the US healthcare system by actually being immersed in a project like this. Right now we're in the midst of conducting a public opinion poll, which is interesting... and very taxing. We're trying for 600 respondents, and have about 250-300 after a week of polling. It seems we're all starting to finally figure out what works in terms of getting people to stay on the phone line and participate in the survey. Today, we're taking a much needed break from polling and are gearing up to hit the phones hard again tomorrow.

I think we're all a bit apprehensive and excited about our upcoming public assembly. It seems were generating a lot of interest in the community, there's just a question about how many of these people will actually show up. It's an uncomfortable feeling that the success or failure of this event is somewhat out of our hands. I know that we'll have the event well-planned, it's just difficult to anticipate how many people will actually show up. I continue to remain cautiously optimistic.

The Disheartening Job They Call "Polling" and Its Future

2008-02-18T22:51:00.001-08:00

by Alex

Our poll is underway and the title says it all. No, it is not that bad. However, it is very disheartening when you call 18 numbers and you do not talk to one Hominidae. In other words, I did not talk to one human, chimpanzee, or gorilla. Ok, I guess the latter two species cannot even talk because they are unable to control their vocal cords. So that leaves me with homo sapiens, or rather, us. Still, would not you think I would at least talk to somebody in that time?

What could it be? Or even better, why am I not getting many "hits"? The development of new technologies (e.g. caller ID) probably has something to do with it. Are people just lazy? Most definitely some of the populace are lazy. Does telephone polling success rest on the sex of the poller versus the sexual preference of the respondent? O yeah, I am currently batting about .900 when the person on the other line is a female.

So of course all of these things (and more) come into play to some extent. I just wonder where public opinion polls will go from here. I know Pew, Gallup, and Rasmussen response rates are trending downwards. We are having limited success ourselves. How are polls going to combat this changing environment? Yeah, internet polls are more prevalent and cellphones are being targeted. However, research shows it is best to talk directly to the source vis-a-vis via telephone.

P.s. Please just pick up your phones and spend 5 minutes talking with us!

James' Reaction

2008-02-14T08:22:00.000-08:00

by James

Things seem to be cranking along, and although we've had some difficulties, I feel pretty positive about our results so far. The information packet is almost complete, and soon we'll begin calling for the poll. I will be uploading the website on Monday (February 18th), which would have been completed sooner, but I've been having a few troubles getting people's photographs taken for the profiles page. However, it's not a big deal in the grand scheme of things.

The time is flying by, as I can't believe it's already Valentine's Day. Before we know it, Spring Break will be here, and the assembly will follow closely thereafter. Whew!

Remarks - Eric's Sh'peel

2008-02-13T12:23:00.000-08:00

by Alex and Zach

Eric is a quasi-Junior Political Science major from Richmond, Indiana. He is also a medical technician in the United States Army. Enjoy!

Healthcare and the 2008 Presidential Campaign

2008-02-10T13:26:00.000-08:00

by Rachel

So now that we've passed Super Tuesday in what could be the most exciting presidential campaign of our generation's lifetime, I thought it would be a good idea to discuss the four major remaining candidates' stances on healthcare. Here is a brief synopsis from cnn.com on each of the four candidates:

Republicans
Mike Huckabee
Says our current system is "irrevocably broken" but opposes federally mandated universal coverage. Would encourage private sector innovation to reduce healthcare costs. Supports market-based approaches at the state level. Would make healthcare more affordable by reforming medical liability, improving electronic record-keeping, promoting portable health plans, expanding health savings accounts, making health insurance tax deductible, and offereing tax credits to low income families.

John McCain
Opposes federally mandated universal coverage. Would increase awareness and promote the use of existing children's health insurance programs while expanding community health centers. Supports healthcare tax dividends for low-income Americans, medical malpractice reform, improving electronic record keeping, expanding health savings accounts, and encouraging small businesses to band together to negotiate lower rates with healthcare providers.

Democrats
Hillary Clinton
Mandates individual health insurance coverage for all Americans. Offers federal subsidies for those who cannot afford it. Allows individuals to choose from among several private plans also offered to members of Congress, as well as a new public insurance plan modeled after Medicare. Requires insurance companies to offer coverage to anyone who applies, and bars insurance companies from charging higher premiums to those with pre-existing conditions. Requires large businesses to provide or help pay for employee coverage. Expands Medicaid and federal children's health care programs. Offers tax credits to limit healthcare premiums to a certain percentage of a family's income. Cost estimated at $110 billion annually, to be paid for by eliminating the Bush tax cuts for those earning over $250,000, as well as reducing waste and inefficiencies in the current system. Also limits the amount employers can exclude from taxes for healthcare benefits for those making over $250,000.

Barack Obama
Would create a national health insurance program for individuals who do not have employer-provided healthcare and who do not qualify for other existing federal programs. Allows individuals to choose between the new public insurance program, or from among private insurance plans that meet certain coverage standards. Requires employers who do not provide health coverage for employees to pay into the national health insurance program. Does not mandate individual coverage for all Americans, but requires coverage for all children. Allows individuals below age 25 to be covered through their parents' plans. Cost estimated between $50 billion and $65 billion, to be paid for by eliminating Bush tax cuts for those earning over $250,000.

The more and more I read about healthcare, the more confused I become as to what the best solution is, at least in my opinion. One definite conclusion I have been able to come to is that Medicare and Medicate either need to be eliminated slowly or they need a radical makeover. I also believe we need a system which promotes preventative medicine, which I think would slowly help cut back on the cost of catastrophic health problems. Those are two things none of the candidates have addressed.

While it is no secret that I'm a Democrat, I like McCain and Huckabee's ideas to make health insurance tax deductible, as well as their desire to improve electronic record keeping, which I think would help improve administrative costs. I do not believe Clinton's idea to mandate healthcare for all Americans would work, and I believe that Obama's plan to only mandate healthcare for children would be much more feasible. I also like how Obama's plan allows for young adults under the age of 25 to be covered by their parents' insurance, especially because I know I won't be done with school until the age of 25 and it would be quite a relief to know I could still be insured under my parents' plan.

No matter who becomes the next president in 2009, it is obvious that healthcare is goning to be one of many issues on their plate. It will be interesting to see where things go, and I can't wait to get our poll started and hold the assembly to see what everyone else around me is thinking.

Indiana Healthcare Legislation (or the Lack Thereof)

2008-02-05T13:27:00.000-08:00

by Alex

So I checked the Indiana General Assembly website for bills relevant to public health policy. Literally, I found not much at all. There were four bills: one dealt with mandating electronic health records systems, one talked about a health insurance for children under the age of 24, one proposed a study commission to focus on a single-payer system for Indiana, and finally one redefined the term "dependent" for Indiana Code sake. Suprisingly, only one made it through the first half of the session and it was the last one I mentioned. After awhile I realized why. Property taxes! The issue that is getting all the attention and probably rightfully so. Especially if you are a legislator. Remember the elections this last fall? Unfortunately, we do not have any interesting proposals or bills to cover for our project. Maybe I would think otherwise if I actually paid property taxes?

Something's Missing

2008-02-05T12:52:00.000-08:00

by Alex

There have been a few studies that show it is actually cheaper to treat people who are obese and those that smoke. I have actually heard this brought up by smokers in the campus smoking ban debate and of course I heard it when I worked down in the State Senate when they passed the cigarette tax increase. I don't mean to discredit the actual study. I do intend to discredit those who use it to argue a point. The one thing that they fail to mention is that we are paying for those who are obese and smoke right now. Yeah, we will save money in the long-run because they die earlier, but they have not died yet.

Let us take obesity for example. Over 30% of people aged 45 to 74 are obese (BMI of 30 or larger). Only 20% of those over 74 are obese. People who are obese are likely to die over the age of 74. Therefore, most of the obese population has not made it to that point yet. Now, the lastest statistics show that an obese person's premium cost annually an additional $2,500 against the premium of an average American. Moreover, obese people do not pay the additional charge. Instead, the money is charged to the whole risk pool, increasing everybody's premiums.

In summation, while it may be cheaper to treat those who are obese or that smoke in the long-run, it is not cheap right now. We are certainly paying for it now. Maybe in 10 years when they start to die off earlier it will become cheaper, but right now it is costing a fortune. I think there is something mission from these findings, thanks for listening. (Note: I am not a smoker and my BMI is 22.8. Plus, I do not necessarily support the smoking ban.)

Rachel's Reaction

2008-01-31T06:38:00.000-08:00

by Rachel

Today I got to go with the TCOM crew to film our first interview in Indy with Dr. John Walker, a family practitioner. I really didn't know what to expect, but I was excited to finally be a part of something dealing with the documentary instead of making phone calls and schedules for the assembly. I have to say, Laura, Jordan, Josh, and Zack have to be some of the calmest people I have ever met! Somehow we managed to forget an entire bag of equipment that contained more lights, umbrellas, and most importantly, camera batteries. We ended up having enough lights, but because we didn't have an extra battery, we were down to one camera. Had that been me, I would have been flipping out. I wouldn't have necessarily shown it, but on the inside I would have been saying many expletives. Perhaps they were doing just that, but they all remained calm and composed, and they seemed to make it work just fine with one camera. Needless to say, I was impressed.

Aside from getting to see the more technical side of things, I was really interested to hear what Dr. Walker had to say. He definitely had a lot of thoughts on the healthcare system, and I was especially impressed and surprised at all the statistics he could reel off not on only on the United States, but on other countries' healthcare systems as well. While he had a lot of great things to say, there was one particular thing that shocked me. Laura asked him something along the lines of what he could do to make a change in our system, which he definitely thinks is broken. He said that he would probably never get involved in the politics of things, even if it were just to write a letter to his representative. he said the most he could do was talk to his patients and get the conversation started. I was so disappointed in that answer. I understand that not everyone is as politically active as me, but as a doctor I believe Dr. Walker could really catch the attention of a politician. After all, doctors are the only people who day-in-day-out have to put up with the problems in our healthcare system. They can provide an insight that no one else can, and I believe if we are going to change our system, then doctors really need to speak up. I look forward to going on more interviews with doctors to see if Dr. Walker's response is typical, or if other doctors are willing to get more involved. Until next time...

Remarks - Rob's Sh'peel

2008-01-30T11:21:00.000-08:00

by Alex and Zach

From week to week here at Hoosiers Debate Healthcare we will post remarks from different members of the team. From now on these we will be called "Video Sh'peels." They will cover really any topic the Sh'peeler wants. Therefore, these are one take opportunities for us to proclaim what we will.

This first Sh'peel comes from Rob Kranc. He is a Senior Telecommunications major from St. John, Indiana. Moreover, Rob is going to like us, he has his own radio show. If you are not doing anything on Thursday's at 9.30, you should tune into WCRD (93.1 FM or stream it live at wcrd.net) and listen to Classic Rock Hour with Rob Kranc. Without further ado...Mr. Kranc!

Samantha's Reaction

2008-01-30T08:17:00.000-08:00

by Samantha

After the first two weeks of being exposed to all this wonderful "interdisciplinary learning," I started to see the effect it was having on my everyday life. I have experienced throughout my college career that everything you learn enhances the way you view things. Enhances could mean realizing value in something you once overlooked or simply asking more questions when discussing a topic. To become educated is to demand more.

Now I'll get off of my soapbox about education and how your mind expands, and get down to what I'm really talking about -- telecommunications. Because I have heard so many new words in the past few weeks, Google definitions has been my new best friend. For example -- define: jib.

In cinematography, a jib is a boom device with a camera on one end, and a counterweight and camera controls on the other. It operates like a see-saw, but with the balance point located close to the counterweight, so that the camera, so that the camera end of the arm can move through an extended arc...

But then there are times when Google definitions is no help. Like learning what the importance of a truck is when shooting a television show. (I'm still not sure I totally understand the concept). This exposure to a new school of thought has damaged my ability to enjoy movies. I suppose that I used to subscribe to the philosophy of ignorance-is-bliss when I can watch a movie and not worry about all the technical things. Now I think, why didn't they bring in more lights to reduce the shadow on the actor's face? I'm sure that the folks who live and breathe TCOM will tell you that this makes your movie watching experience more enjoyable because now I can identify better quality movies. However, I think it's going to take some getting used to.

The first time I saw all the lights set up in the living room for Khatib's interview, I was amazed. The behind-the-scenes work that has to be done is unimaginable, and that's only if things go smoothly. We are lucky enough to be allowed to study in the Kitselman Mansion, but sometimes the old wiring cannot withstand the demand of necessary TCOM equipment.

So, in short, this is my ode to a new school of thought and interdisciplinary learning. I have to admit, it is a fun environment to experience this because I don't have to read a book about it my freshman year and then wait until my junior year to have a hands-on experience. It's all happening this semester, whether we are ready for it or not.

Jordan's Reaction

2008-01-30T08:06:00.000-08:00

by Jordan

I really wanted to get out in the field and start shooting this week, but we did have at least one interview and granted it was in the house. But still we got something on tape! It seems that all we have done up until now is just talk about doing things. And we had a few problems and bumps in the road, but overall it was a good experience. I hope to have it edited together by next week to show people the fruits of their labor so someone other than just the production students can look at it, seeing that we are actually doing something. That is what I love about what I do -- to be able to take these tools and make something out of them.

I am really excited as we go forward. I think that we have a good team of people here. We have some kinks to work out in the process, but I am sure with all the highly motivated, highly skilled people I have around, we will do well.

State of America's Hospitals: A Grady to Wishard Comparison

2008-01-29T17:57:00.000-08:00

by Alex

Grady Memorial Hospital is to Atlanta as Wishard Memorial Hospital is to Indianapolis. Like Wishard, Grady is a teaching hospital, it serves nearly all the region's uninsured, and it has the only Trauma 1 center in Atlanta. Unfortunately, like Wishard, Grady is facing financial troubles. In fact, there are about 300 fewer public hospitals today than there were 15 years ago because of this reason. The current Grady model is unsustainable. One third of their patients are uninsured. Another third are covered by Medicaid, which reimburses at a really low rate. The point is many hospitals, many of the nation's safety nets, of Grady and Wishard's form share the same problems. The healthcare "crisis" is debatable, but the state of our countries hospitals is not. Somewhere in our system, synapses are not firing.

What is the Value of Life?

2008-01-29T10:07:00.000-08:00

by Alex

A healthcare system is in place to prevent and treat different ailments and conditions so to protect the mental and physical well-being of our lives. The problem is that every healthcare system allows some to slip away. The London School of Hygiene and Tropical Medicine estimates that the United States allows for about 100,000 unnecessary deaths per year. These are the people who lack health insurance and the ability to access proper care. Policy-makers and other experts debate whether providing care to the uninsured would actually be better and less costly than the status quo. (I have my own opinion and you have yours, so we will just leave that for another day.) In this case, we always think in terms of how much it will cost to cover them and whether the benefits outweigh the costs. But what if all the sudden we were to consider the options based on the actual cost of life?

What does your life cost? I have really no clue, but many economists have recently tried to figure out just that. They measure it by observing real choices, for instance whether you will cross the street at the cross walk or play Frogger during rush-hour. One of the largest choices you make is in choosing your profession. In that case, people who choose a more risky occupation (e.g. drug dealer, prostitute, stunt driver) value their life less and vice versa. (If you are interested, economists have measured a Mexican prostitutes life value at around $50,000 per year and that of a Chicago drug dealer a little more than that.) So, we could add up all of the 47 million people who are uninsured and find out how much we value their life collectively. That price tag would be compared to the amount it would cost to provide them with healthcare coverage. Would it be worth it? (Ok, I know I am leaving many factors out of the equation, but I am just trying to make a point.)

In summation, I do not know if that is the best metric to use in deciding whether the costs of healthcare is worth it, but it certainly brings up a different way of thinking. Is a system that allows for 100,000 preventable deaths per year justified? I guess that is up to you. What do you weigh the cost of life?

Doctors Can Prescribe Off-Label Drugs

2008-01-29T07:06:00.000-08:00

by Alex Beeman

I will stumble upon many interesting things throughout my research. While most of these issues and factoids will not be referred to in the movie, I will try to shed some light on them in this blog. So without further ado, I was reading an article on Slate that really surprised me. As the title of the post proclaims, doctors actually have the ability to prescribe prescription drugs that are not approved by the Food and Drug Administration (FDA). Why? Well, the government actually cannot regulate or tell a doctor how to practice medicine. This article supports doctors' autonomy in this instance, explaining that it allows for innovation. the author, who is a physician, cites that two-thirds of off-label drugs have resulted in the discovery of other uses. The number of off-label prescriptions is not insignificant either. One study showed that "roughly one-fifth of prescriptions for the 169 most common drugs were for off-label uses."

WIPB-TV Assembly Announcement

2008-01-28T09:18:00.000-08:00

by James Raymond

We will be hosting our Deliberative Democracy assembly, in conjunction with WIPB-TV, at the Minnetrista Center, on Sunday, March 16, 2008. This event will allow Muncie citizens from all walks of life to come together and talk, question, and listen about healthcare from experts and discuss the issues amongst themselves.

Michael's Reaction

2008-01-24T08:46:00.000-08:00

by Michael

It seems like the warning that the group before us was more true than I realized. While collectively there is no one in the world that we don't know, we are getting bogged down in waiting, and cannot ask people to share what they know, because we don't know when they should come. Besides spinning the wheels and not going anywhere, everything else is going well. The house, oh the house is AMAZING. I call people to see where they are, when we are both in the house. Everyone in the group works well together. We have yet to have a type A coup d'etat, which I'll admit I was a little worried about. So that's good. What else? Oh yeah, internship reports are the worst.

Until the end of it all,
Michael

Healthcare Policy as Antibacterial Soap

2008-01-24T08:23:00.000-08:00

by Alex

Courtesy of Jessican Hagy at Indexed, this card alludes to the systematic relationship between health warnings, antibacterial soap, and superbugs. A superbug is basically a Rambo-like microorganism (e.g. bacteria) which is able to fend off attacks from antibiotics (e.g Penicillin). They have linked an overuse in antibacterial soap (e.g. hand sanitizer) to the increased resistance of microorganisms. One of the most popular superbugs is Methicillin-resistant Staphylococcus aureus (MRSA). It has evolved the ability to deflect assault from most antibiotics which inevitably means that it is hard to prevent and spread. The point is, any choice we make in life has tradeoffs. Some choices will result in the good and some will result in the bad. Like antibacterial soap, healthcare policy can be a salvation as well as a liability. So, replace "B=Antibacterial Soap" with "B=Healthcare Policy" and think about it.

Parkinson's Law

2008-01-24T08:12:00.000-08:00

by Alex

I cannot help but to observe the anxiousness in us all. Unfortunately, this is followed by my continued praise of Parkinson's Law. In 1955, a cheeky British naval historian named Cyril Northcote Parkinson proposed the idea that work expands to the time allotted. His theory developed from the observation of Her Majesty's Civil Service, in other words, British bureaucracy. I cannot help but analyze as he did over 50 years ago the same thing. Basically, it is inevitable that procrastination will occur to a degree. While this negative statement will certainly resonate within our work, I am confident we have the skills, the will, and bills to make a "dang good documentary."

What to Expect

2008-01-23T11:07:00.000-08:00

by James

As this Virginia Ball Center project progresses, you can expect to see the venting of emotions, the excitement of breakthroughs, the joys of accomplishing large tasks, and all the various ups and downs that will accompany our work. It will be an interesting semester, no doubt, but we're up for the challenge.