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Health Care Meltdown: Confronting The Myths and Fixing Our Failing System

Bob LeBow, M.D., M.P.H.
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Instead of seeing a $60 million ad campaign about the "bus from Canada," I'd like to see the drug companies, the insurance industry, and the AMA pool their resources on a $60 million publicity effort to persuade Americans to support national health insurance. It wouldn't be so impossible if business joined the bandwagon. Timing is key. If the "Perfect Storm" should happen—and past forecasts of both weather and health care crises have been known to be fickle—then the grassroots support should be there to assure that the corporate guys can't pull off another shell game.

How to Get Out of the Hospital Alive: A Guide to Patient Power

Sheldon P. Blau, M.D., F.A.C.P., F.A.C.R. and Elaine Fantle Shimberg
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The informed patient is a threat to the health insurance industry. If your primary physician is on your side, so much the better. It's (sometimes) a winning combination. 12. If you're not satisfied with the treatment you've received from your managed-care organization, talk about it with others. You may not be the only unhappy subscriber. Remember, for them it's a business and too many lost subscribers can affect profits; for you and your family, it's your lives. Doesn't that make it worth fighting for? 13. Write to your state legislator or Congress representatives or contact the media.
If ever there was an argument for socialized medicine, it's the insurance industry itself Managed care means managed economics. My insurance policy cost $12,000 a year. Despite the premium, the number-one priority of the insurance company is not to pay the claim or to pay less of it than it costs. Words like "deductible," "co-pay," "reasonable charge," and "prevailing fee" are created by the insurance company to give you less than you thought you were going to get.

Health Care Meltdown: Confronting The Myths and Fixing Our Failing System

Bob LeBow, M.D., M.P.H.
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Groups (such as the insurance industry, the pharmaceutical companies, and some elements of the medical care establishment) with special financial interests in our health care system will likely continue to play games of disinformation to derail significant change. And they will twist the mantra of "personal responsibility" to make people believe that financial barriers to care, like increased deductibles and co-pays, are good for them. They will invoke the "mantra" of "socialized medicine" to attack any increased role for government.
This theory has major support from the insurance industry. But in fact the primary motivation behind the industry's support for co-pays and deductibles is financial: a) Financial reason #1: If the co-pays are substantial enough (say, $20 for a prescription or several hundred dollars for the Medicare inpatient deductible), they force the patient to share directly in a major portion of the cost of their health care. The expense to the insurer is thus diminished. b) Financial reason #2: Co-pays and deductibles act as a barrier to care and reduce utilization.
It would be far from universal, do nothing to decrease administrative costs or complexity, and give a huge gift to the insurance industry. Moreover, it would further institutionalize a multi-tiered health care system in the U.S. As Uwe Reinhardt, the Princeton health economist, said about "incremental" reforms in 1999, "The problem lies in the self-destruct mechanism inherent in the very idea of incre-mentalism. Even Mother Theresa probably could not make incrementalism work any better. It has been thus and it always will be thus.

How to Get Out of the Hospital Alive: A Guide to Patient Power

Sheldon P. Blau, M.D., F.A.C.P., F.A.C.R. and Elaine Fantle Shimberg
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The vast amounts of money being made by the insurance industry on the backs of sick people is one of the great inequities of our society. It is unjust and immoral for people who are ill to be penalized in so many ways. Truly great societies will be remembered by the care they give to their most disadvantaged members. The final lesson I learned from my canceled morgue appearance is the power of positive thinking, which my coauthor and I wholeheartedly subscribe to and practice. We believe that we are all potentially either victims or survivors.

Health Care Meltdown: Confronting The Myths and Fixing Our Failing System

Bob LeBow, M.D., M.P.H.
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The traditional opponents of comprehensive change such as national health insurance have been the AMA, the insurance industry, the pharmaceutical industry, and certain other business interests. After the reform debacle of 1994, politicians looked at comprehensive change with the deference owed a third rail. Popular wisdom dictated that the only politically safe route to take in efforts at health care reform was the path of "incremental" change. What have the incremental efforts of the past decade brought us? We've seen an increase of about five million in the number of uninsured.

New Choices in Natural Healing: Over 1,800 of the Best Self-Help Remedies from the World of Alternative Medicine

Bill Gottlieb
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This willingness to consider alternative therapies is also beginning to spread to the health insurance industry. A few large carriers have started to experiment with covering alternative treatments. A pilot program at Mutual of Omaha, for instance, covers the Dean Ornish cardiac rehabilitation program, and Blue Cross of Washington has a policy that covers naturopathy and homeopathy. But no carrier has made a greater commitment to natural healing than the American Western Life Insurance Company of Foster City, California.

Health Care Meltdown: Confronting The Myths and Fixing Our Failing System

Bob LeBow, M.D., M.P.H.
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Or the insurance industry, which can make large profits by selling expensive MediGap policies or Medicare+Choice plans, which they can drop at will if they see their profitability threatened. Leaving their clients high and dry is no problem— not if the insurance company is losing money. And then there are the entrepreneurs, including the current administration and CMS Administrator Tom Scully, who would "reform" Medicare by privatizing it. It could be turned over to corporate America and transformed into a multi-tiered system where the rich would get one kind of care and the poor another kind.

The One Earth Herbal Sourcebook: Everything You Need to Know About Chinese, Western, and Ayurvedic Herbal Treatments

Alan Keith Tillotson, Ph.D., A.H.G., D.Ay.
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Because of the horrific cost of poorly managed diabetes, and because it is so easy to avoid or slow the onset of problems with simple lifestyle and diet changes, specific programs designed to increase patient awareness and compliance are now rapidly being developed by the health care insurance industry. It is possible to live a long and healthy life with diabetes. As I mentioned in the Introduction, I was diagnosed with Type 1 diabetes (IDDM) in 1961 at the age of 11. Now, almost 40 years later, I have not suffered any major diabetes-related health problems.

20 Years of Censored News

Carl Jensen
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Emission standards are delayed. insurance industry contributes $450,000. Product-liability limits are pushed. Airlines contribute $315,700. Limits on noisy engines are reduced. The coincidental relationship between contributions and deregulation was not lost on George Bush. On April 29, he extended his original 90-day moratorium on new federal regulations for another 120 days. SOURCES: The Nation, 3/23/92, "Bush's Regulatory Chill: Immoral, Illegal, and Deadly"; The Progressive, May 1992, "Deregulatory Creep: Dan Quayle Clears the Way for Industry," by Arthur E. Rowse.

Toxic Sludge is Good For You: Lies, Damn Lies and the Public Relations Industry

John Stauber and Sheldon Rampton
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According to Robin Toner, writing in the September 30, 1994, New York Times, '"Harry and Louise' symbolized everything that went wrong with the great health care struggle of 1994: A powerful advertising campaign, financed by the insurance industry, that played on people's fears and helped derail the process.
In 1993, Childs recalled, "The insurance industry was real nervous. Everybody was talking about health care reform. . . . We felt like we were looking down the barrel of a gun." Forming coalitions, he explained, is a way to "provide cover for your interest. We needed cover because we were going to be painted as the bad guy. You [also] get strength in numbers. Some have lobby strength, some have grassroots strength, and some have good spokespersons. . . . Start with the natural, strongest allies, sit around a table and build up . . . to give your coalition a positive image.
The congressional staffers fielding the calls typically had no idea that the constituents had been primed, loaded, aimed and fired at them by radio ads on the Limbaugh show, paid by the insurance industry, with the goal of orchestrating the appearance of overwhelming grassroots opposition to health reform. "That's a very effective thing on a national campaign and even in a local area if the issue is right," Childs said. He said this tactic is now widely used, although few will discuss the technique.
Do you need to know which PR firm or lobbyist is representing whom in Washington, or whether the Coalition for Health Insurance Choices is an insurance industry front group? Then you should probably get the best annual directory to the action inside the Beltway: Washington Representatives: Who Does What for Whom in the Nation's Capital, Columbia Books, Inc., 1212 New York Avenue, Washington, DC 20005; phone (202) 898-0662. Another useful resource, published in 1995 by the nonprofit Advocacy Institute, is titled By Hook or By Crook: A Guide to Stealth Lobbying Tactics and Counter-Strategies.
Childs, who has been organizing grassroots support for the insurance industry for a decade. From 1986-89 he orchestrated a media, grassroots and coalition-building campaign for the industry's American Tort Reform Association. Then he moved to Aetna Life and Casualty where he instituted one of the most sophisticated corporate grassroots systems in the nation. He wasn't the only PR genius behind the anti-health care campaign, but his coalition can honestly claim the kill.

Every_Persons_Guide_To_Antioxidants

John R. Smythies
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This book will also be of interest to those who work for government health programs, including Medicare, and nongovernment organizations concerned with healthcare delivery; the health insurance industry; and any others who are responsible for public health policy and funding. The measures this book supports have the potential not only to reduce the amount of chronic diseases suffered by people but also substantially to reduce the current crippling costs of medical care. Knowledge of chemistry is not necessary to read this book.

The Big Fix: How the Pharmaceutical Industry Rips Off American Consumers

Katharine Greider
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Waste!" Researchers at the Harvard School of Public Health recently compared cost-effectiveness studies according to who had paid for the research. On average, those funded by the drug industry reported by far the best cost-effectiveness ratios; those funded by health-care organizations reported by far the worst. Unfortunately, such research is too complex to simply split the difference. Likewise, there are reams of data comparing the efficacy of particular drugs to placebo, but few that compare them with each other.

The Medical Racket

Martin L. Cross
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We must assume that most doctors are still honest, but a pernicious epidemic of dishonesty has infected the medical profession and is helping to bankrupt Medicare, Medicaid, and the health insurance industry. It infects not just the fee-for-service physician, but the hospitals, the HMOs, the dentists who are compensated by Medicaid and private insurers, the medical equipment distributors, the testing laboratories, the home care industry, the nursing homes, and virtually everyone who calls himself a "health provider.
The answer is to invent a whole new system that is indebted to neither Washington, the HMOs, the insurance industry, or the doctors. Instead, we need a methodology that puts patients first, last, and always. Is it possible? I believe so, if the various special interest groups, including our politicians, would stop their selfish intransigence and false ideologies of left and right and start to concentrate on the American genius for civic good sense. Who do Americans trust? Distant politicians? Absolutely not.

The Politics of Cancer Revisited

Samuel S. Epstein, M.D.
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It is questionable whether the insurance industry would profit from disease prevention as their decreased payments to the sick would be more than negated by increased payments for long-term pensions and retirement policies. While public interest groups and organized labor have emerged as the only coherent anti-cancer lobby, they have yet to impact significantly on a national grassroots level.
Recognizing the reality that one in four of us will sometime need cancer treatment, and that the costs will not be adequately covered by conventional policies, the ever-responsive insurance industry is now offering cancer policies which you may want to investigate. About 60 percent of these policies are writ- $ It is important to note that the "cancer surveillance programs" adopted by industry for lung or liver cancer most certainly do not offer prevention, but merely the earlier diagnosis of an inevitable death.

Rockefeller Medicine Men: Medicine and Capitalism in America

E. Richard Brown
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The AMA, the insurance industry, and the American Hospital Association have all submitted bills that would favor their members. The AFL-CIO and most bureaucratic professionals support the successive bills sponsored by Senator Edward Kennedy. The Kennedy bills would go farther than other national health insurance bills in providing comprehensive and accessible care. Some versions of the bill would even eliminate any administrative or third-party role for insurance companies. All versions include an incentive payment system to encourage physicians to join prepaid group practices.

The Herbal Medicine-Maker's Handbook

James Green
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Currendy vivisection is employed by many other commercial industries as wed to appease the insurance industry. Reviving the art, science, and language of Herbalism for enhancing human health simply does not require the pain and suffering of other species to generate credibility, nor is this required in any way for lay herbalists to continue developing insight into the use of plants for nourishment and weU-being. I don't see how the carnage and abuse of non-human species will somehow render human beings more healthy and happy.

Oxymorons: The Myth of a U.S. Health Care System

J.D. Kleinke
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Their biggest political enemy was not, interestingly enough, the traditional health insurance industry. According to Starr (1982), it was the well-organized, well-funded physician community that, with great prescience, saw the collectivization of contracting under the MCOs as a threat to its financial self-determination. Somehow, the physician lobby sensed—all the way back in 1973—that the collectivization of its services under the first MCOs would one day produce a contract like the one on Dr. Chang's desk today.

Herbal Defense

Robyn Landis
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This double standard is in effect in science, medicine, and the insurance industry as well as the lay public. Witness Dr. Dean Ornish's struggle to find funding to study his lifestyle program and, even now, to have insurance companies cover it— even though those same insurance companies will spend $12 billion annually on bypass surgeries, at $30,000 to $40,000 apiece, half of which will need to be redone within 5 years, and another $4 billion annually on angioplasties at $10,000 each, almost 40 percent of which need to be redone in 4 to 6 months.

Food Revolution: How your diet can help save your life and our world

John Robbins
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There is today no insurance whatsoever against the kinds of catastrophic losses and tragedies that could ensue from introducing transgenic organisms into the environment and into the human food chain. The insurance industry has consistently not been willing to place insurance premiums on the potential for loss that is involved.68 The European Community has expressed a few concerns as well. In 1999, London's newspaper, the Independent, announced that "European governments are drawing up contingency plans for a nuclear fallout-style emergency involving genetically modified organisms (GMOs).

The Cancer Industry

Ralph W. Moss, Ph.D.
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Because the insurance industry is a decentralized industry," Mary McCabe, a clinical trial specialist at the NCI's Cancer Therapy Evaluation Program, explained, "reimbursement for a specific therapy is made in some areas of the country with some insurance carriers but in other places for that same therapy, it is not," (Infectious Disease News, January, 1989). She noted: In the past, they [i.e., insurers] inconsistently or infrequently invoked that exclusion, and they have paid.

Your Doctor is Not In: Healthy skepticism about national health care

Jane M. Orient, M.D.
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There are some problems with the insurance industry, and these should be reformed. The most important reform is to sever medical insurance from employment. Insurance should be personal and portable. If you change jobs, you should be able to take your insurance with you, even if your employer paid the premiums. After all, you earned it—insurance benefits are really a substitute for higher wages. Medical insurance should also be noncancelable, like many life insurance policies are, and there should be built-in protections against unreasonable increases in premiums.

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