Why US Women Die in Childbirth
Posted on | March 14, 2019 | 1 Comment
Code Blue Receives Kirkus Star
Posted on | March 13, 2019 | Comments Off on Code Blue Receives Kirkus Star
KIRKUS REVIEW
“A doctor and medical historian relies on his experience inside the medical establishment to offer a searing and persuasive exposé of the American health care system.
Magee, who is on the faculty of Presidents College at the University of Hartford, has worked as a doctor, a university medical school administrator, a hospital executive, and head of global medical affairs for Pfizer. About that last position, the author writes, “until I turned away in a kind of revulsion at the manipulation and well-financed maneuvering, I was right there, helping give moral cover and scientific legitimacy to the world’s largest drugmaker, which also happens to be an industry leader in penalty fees paid to the government for regulatory infractions.” Clearly, Magee understands that he has been complicit as an insider, and he issues mea culpas throughout the book. As part of his penance, he blows the whistle on guilty individuals involved with pharmaceutical companies, hospitals, health insurance corporations, the American Medical Association, medical schools, and all levels of U.S. government. Referring to this “network of mutually beneficial relationships” as the Medical Industrial Complex, he convincingly rails against an industry that consistently produces “outcomes that are, in general, truly dismal.” The inferiority of U.S. health care compared to dozens of other nations has been well-documented for several decades, and the author effectively builds on that documentation. He demonstrates how leaders of other nations have consciously decided that quality health care is a basic right for all citizens, in large part because a healthy citizenry is essential to economic well-being. However, decades ago, American leaders decided that quality health care was not a basic right of citizenship; instead, they chose to rely on market capitalism as the health care model, with disastrous results. Magee suggests multiple sensible reforms in the realms of medical education, clinical research, publication of medical trials, marketing by pharmaceutical companies, and politically driven interactions within the MIC.
Readers will hope that Magee’s knowledgeable, urgent indictment, following so many others in recent years, will lead to meaningful reforms.”
Partnership to Sustain America’s Health Care Past
Posted on | March 4, 2019 | Comments Off on Partnership to Sustain America’s Health Care Past
Mike Magee
On the surface, there appears to be a fair amount of finger-pointing going on among and between members of the Medical Industrial Complex these days. But this circular firing squad has no bullets. Behind the scenes the founding MIC members are busy colluding, sharing profits and defending the status quo.
Case in point: The Partnership for America’s Health Care Future. It is a faux-partnership whose real purpose is to preserve the past rather then chart a progressive future.
The party line, voiced by the CEO of the for-profit hospital association (a member), is “We have a structure that frankly works for most Americans. Let’s make it work for all Americans. We reject the notion that we need to turn the whole apple cart over and start all over again.”
It’s a slippery coalition, but it’s main members pack a wallop. When you go to the website, its 27 members are represented by logos with no active links. It’s one of those lobbying efforts that’s intentionally on the “down-low”; a quasi-organization whose name may soon appear as a tag line on a third generation of “Harry and Louise” ads.
In the interest of transparency, here’s a list of the 27, segregated into Leaders, Followers, and Facilitators.
Leaders:
1. American Medical Association (AMA) – the doctors
2. American Hospital Association (AHA) – the non-profit hospitals
3. Federation of American Hospitals (FAH) – the for-profit hospitals
3. America’s Health Insurance Plans (AHIP) – the major insurers
4. Pharmaceutical Research and Manufacturing Association (PhRMA) – the drug makers
5. Biotechnology Innovation Organization (Bio) – the biotechnology companies
6. Association for Accessible Medicines (aam) – the generic drug producers
7. Council of Insurance Agents and Brokers (The Council) – the health insurance brokers
8. Healthcare Leadership Council (HLC) – the coalition of MIC CEO’s
9. National Association of Insurance and Financial Advisers (NAIFA) -The financial/insurance industry
10. National Association of Health Underwriters (NAHU)
Followers:
2. Hospital Corporation of America (HCA)
3. Ascension Health (largest Catholic HC System)
5. Community Health Systems (CHS)
6. Life Point Health (Holding Company for 70 health care institutions)
7. Tenet Health
8. UHS (Universal Health Services) – manages 350 hospitals
9. Texas Health Resources (faith based 29 hospital system)
10. Premier Inc. (Health Data mining company)
11. Life Point Health (Holding Company for 70 health care institutions)
13. North Dakota Medical Association (NDMA)
14. American College of Radiology
Facilitators:
1. National Osteoporosis Association
2. Retire Safe
The Facilitators are only three in number now, but are certain to grow. They have in common a heavy financial dependency (either as grantees or clients) on and history with the Leaders. For example, the National Osteoporosis Foundation has been in the middle of the “Vitamin D for all” research controversy. Retire Safe is an industry dependent alternative to the AARP. And then there’s “healthy women” marketed as “the nation’s leading independent, nonprofit health information source for women.”
When you look under the hood of MIC facilitator organizations, you will find extensive lists of professional and corporate “advisers”. This helps reveal the association’s funding, and often the quid pro quo behind their financial survival. But for a look at daily operations and priorities, examine the affiliations of Board members.
For example, here are the Board members for healthy women:
Violet Aldaia (Vice Chair), SVP Omnicom, former Viagra marketer for Pfizer
Julia M. Amadio, Chief Product Officer at TherapeuticsMD
Kristin Cahill, President GCI Health, North America
Nancy Glick, SVP MS&L
Amy Landucci, CIO of GSKs Consumer Health
Wes Metheny, former PhRMA SVP of Advocacy
Brian O’Connor, VP of Alliance Development for AdvaMed
Oxana K. Pickeral, Ph.D., MBA (Immediate Past Chair), President BioVenture LLC, former Booz Allen Life Sciences practice
Elisabeth Ritz, former Eli Lilly Global Communications, former consultant to Edelman, Hill&Knowlton and Ogilvy.
Kristina K. Saunders, CFP, CIMA, SVP Farr, Miller & Washington
Lynn A. Taylor, SVP Government Relations Merck KGaA, Germany
Tomeka Thomas, Director at Cigna/Bravo Health Springs, former UHC Evercare
Tamar R. Thompson (Chair), Exec. Dir. State Government Relations, Bristol Myers Squibb
Christine Verini (Treasurer), VP Corporate Communications and Advocacy Eisai Inc
They share in common health industry backgrounds, either as employees or clients, with a heavy emphasis on government relations and advocacy, PR communications and marketing. They are likely deeply involved in charting the communications and advocacy strategy for The Partnership for America’s Health Care Future.
Some of these vibrant and conflicted service organizations do great good. They are part of America’s “thousand points of light” – our nation’s answer to the lack of funding and support for national health planning, prevention, and social service integration seen in all other developed nations. This disintegrated health services network survives on the crumbs of a federally underwritten, profit seeking MIC.
Our facilitating “patient service” organizations like healthy women are charitably funded by MIC members, and in return are expected to defend their flanks against progressive reforms and appropriate checks and balances.
Camouflaged as a “partnership for America’s health care future”, what this is in reality is a partnership to sustain America’s health care past.
“Where’s the Beef?” Water as Currency.
Posted on | March 1, 2019 | 3 Comments
Mike Magee
“They want to take your pickup truck. They want to rebuild your home. They want to take away your hamburgers. This is what Stalin dreamt about but never achieved”, screeched former White House aide Sebastian Gorka at the Conservative Political Action Conference this week.
His widely discredited remarks were called out by a range of environmental scientists who laid out the role of American’s dietary habits as contributors to carbon dioxide production and global warming. For me, it recalled the slide above, part of a year long speaking tour I conducted in 2006 in support of the publication of Healthy Waters. The slide demonstrates the relative consumption of water resources to produce 1 kg of grain, versus 1 kg of chicken or beef as food.
Remarkably, we Americans require approximately 3 liters of water a day for survival, but the average America diet (heavy in beef) requires an investment of 3000 liters of water a day.
As the slide above from the same presentation illustrated, 70% of our water consumption is in support of our dependence on meat-heavy agriculture in this country.
It’s easy to make the case, for human health reasons alone, to shift in the direction of a plant based diet. What is more easily overlooked is that Americans obsession with meat has threatened in equal measures the planetary patient through its contributions to global warming and water consumption.
The Road to Universal Coverage
Posted on | February 26, 2019 | 1 Comment
Mike Magee
New York Times columnists. Austin Frakt and Aaron Carroll, provided a genuine public service this week in offering an interactive exploration of universal health care. Readers were asked to react to the same questions presented to a bevy of health gurus.
Their 5 “Yes or No” questions were:
1. Do you support automatic enrollment in universal coverage?
2. Do you support ending employer-based private coverage?
3. Do you support replacing individually purchased private coverage, like Affordable Care Act plans or Medicare Advantage?
4. Do you support eliminating premiums and having the system financed exclusively by taxes?
5. Do you support eliminating cost sharing — meaning co-payments, coinsurance, deductibles — for everyone?
Following each vote, you are able to see the % who voted “yes” or “no”. Then there is commentary from health policy notables explaining why they voted the way they did. Spoiler alert – majorities are leaning toward big change.
The national scale is obviously tipping toward idealism and solidarity with significant push back from pragmatists/realists explaining – usually based on taxation/financing – why what logically should be done is just not politically feasible.
What is missing from the piece above, and from many others on the topic, is an obvious truism: Universality is dependent on two co-determinants – mandatory participation and transformational efficiencies.
In short, we can afford health care as a universal right for all only if we share the risk and halt profiteering collusion by the Medical-Industrial Complex.
Consider these two facts:
One in five American dollars now go to health care – we spend close to twice the amount of most other developed nations.
There are 16 health care employees for every one physician in America – and half of these 16 have absolutely no clinical purpose.
Stories of profiteering and financial abuse abound, and I review many of them in Code Blue: Inside The Medical Industrial Complex (Grove Atlantic) due out on May 7, 2019. But let me share just one recent case that illustrates the near racketeering level of absurd waste in our system as described in an investigative ProPublica piece last week.
It seems that nearly all the major health insurers have been secretly greasing the palms of the 100,000 plus U.S. local health insurance brokers to push their products on small and large employers nationwide. Secretly, the brokers have been collecting a 3 to 6% commission on every premium, which for a company of 100 people amounts to a $50,000 plus annual fee. And that’s for the regular plans. If they sell you supplemental plans (for drugs, dental, optical etc.) the commissions are richer – much richer. 40% to 50% to be exact because the benefits often go unused.
Scaling that up, BC/BS’s service of 15 million employees in 5 states generated $816 million in broker bonuses in 2017. And they and other big players like Cigna, United Healthcare and Aetna offer no apologies. To them it’s the price we pay for good, clean competition.
And then there is Morris County, New Jersey, where one fast-talking broker convinced the county’s HR people to switch coverage to Cigna and effectively concealed the administrative charges for the switch – over $800,000. The county is now suing, and consuming more local taxpayer dollars in the process.
A significant and growing contingent of consumer advocates favor big change. Why? Because they realize that crooks thrive in the cracks of complexity. Simplify is their true rallying call, and eliminating steps and “non-real” work is the surest way to finance health care for all.
The Planetary Patient
Posted on | February 12, 2019 | Comments Off on The Planetary Patient
Mike Magee
In 2005, I published a book called Healthy Waters in an attempt to raise environmental health and the deteriorating “planetary patient” as a pressing health care issue. My efforts were only modestly successful.
Chapter 8 in the book was titled “Natural Water Disasters” and summarized the costs in human life and fortune as a result of global warming and environmental degradation.
At the time, no natural disaster had generated more powerful and destructive images than did the tsunami that struck Asia and Africa in December of 2004. That single event, in dramatic fashion, illustrated both the power of water and the vulnerability of coastal and river basin populations.
At the time , CO2 levels were 380 parts per million. Now 13 years later, they have risen to 410 ppm. In the age of Trump, manufacturers global carbon emissions have risen from 27 billion tons of CO2 a decade ago to 37 billion tons of CO2 in 2018.
A recent article in the Washington Post on the topic is simply headlined, “We are in trouble.” The Paris Accord had us heading in the right direction with global emissions flat between 2014 and 2016. But in 2017, global emissions rose 1.6% and in 2018 grew 2.7%. In that year, US emissions grew 2.5% while EU emissions declined -1%
Outlining the damage caused by global warming already to our planet would take more room than we have here. In fact, the federal government delivered a 1,700 page congressionally mandated climate impact update to Trump on Thanksgiving, 2018, which left little room for thanks. This came one month after the President’s appearance on 60-minutes where he said, “I don’t know that it’s man-made” (and that the warming trend) “could very well go back.”
Of note in the report: The continental U.S. is 1.8 degrees F. warmer and our seas 9 inches higher than they were 100 years ago.
You don’t have to convince Miami’s Chief Resilience Officer, Susanne Torriente, that there’s a problem. She said, “We don’t debate who caused it. You go outside, the streets are flooded. What are you going to do about it? It’s our reality nowadays. We need to use this best available data so we can start making decisions to start investing in our future. … It shouldn’t be that complicated or that partisan.”
A decade ago, New York Times columnist, Tom Friedman, launched the term “Green New Deal” covering a range of activities he thought might treat the planetary patient’s environmental illness.
The term has now been picked up by Rep. Alexandria Ocasio-Cortez (D-NY) to encompass a range of progressive goals including climate related initiatives. Some claim it will be a litmus test for Democrats, while others predict it will be their demise.
But as the victims of the recent California fires could easily attest, the risk is growing. Back in 2006, I wrote, “Absent preparedness, the losses are complex and considerable, measured in human life and the loss of social, economic and environmental capital. Such disasters are increasingly magnified through human error, can occur out of nowhere, and generate highly uncoordinated responses. Poor and marginalized populations are most often the victims with secondary down cycling of health status a predictable end effect.”
It was true then, and even more so now.
Tags: Carbon levels > clean energy > global warming > trump > US climate Report
“blank”…. FOR ALL.
Posted on | February 11, 2019 | Comments Off on “blank”…. FOR ALL.
Mike Magee
In a Washington Post interview this week, Rep. Donna Shalala, former head of HHS and now a member of Congress from Florida, suggested that democratic reformers focus on universal coverage by whatever means possible. In her view, this includes opening up voluntary access to Medicare (50+), Medicaid (more liberal entry standards), employer based insurance (for employees kids up to age 30), ACA exchanges (with increased subsidies to enhance affordability), and reinforced CHIP.
Without saying it, Shalala and others believe that you don’t have to strong arm people or restrict choice of coverage to make progress. You just need to offer them better options. Her major point, forged by the pragmatism of someone who has been in the battle for a long, long time, is that mandated universal coverage or the “blank…FOR ALL” is what matters – through whatever means possible.
She cites as one example the natural expansion of ACA funded Medicaid which has now been adopted by 37 states (including D.C.), leaving only 14 (out of 33) Republican governor hold out’s.
Despite Trump’s attempts (echoed vigorously on FOX News) to brand efforts to establish “Medicare-for-all” the way Medicare was attacked a half century ago as big government “socialized medicine”, the majority of governors has tacitly acknowledged what Warren Buffett was right when he described the health care status quo as “the tapeworm of American economic competitiveness”.
The decline of state economies reinforced by the burden of weak social service systems, challenged and undermined by a raging opioid epidemic, had caused Republican governors like John Kasich to declare independence when it came to health policy.
Expanded Medicaid celebrated a new approach (within the corridors of defined eligibility) of universality, access, health planning, portability, and integration with other social service programming. Participating governors liked the fact that the program was well funded, that the benefit package was broad (not a sham skimp HSA product), and that they preserved the flexibility within bounds to set the priorities on spending and were allowed to define how best to advance the overall health of their state populations.
The governors learned that centralized administration of a universally available health insurance offering carried distinct cost savings. Specifically, governor guided single payer health delivery under Medicaid came in 22% less costly than privately insured comparators.
Participating governors well understand that the U.S. is the only civilized nation in the world where more is spent on the mechanics of disease fighting than on all social services combined – the very combination of services and supports that help keep a population well.
Given the power and flexibility under Medicaid, they can redeploy essential human health resources. For example, as wildly expensive nursing home use declines, those employees, now mobile are a potentially useful and experienced mobile home services health corps. Given room for experimentation, as they have been under the ACA, governors have applied both innovation and structural remodeling to expand safety, security, and health across multi-generational families.
Despite Trump and McConnell opposition, The Medicaid single payer authority experiment has gone large scale. Under the direction of autonomous state leaders, nearly 80 million have received care of late with extraordinary high satisfaction levels. 34 million of these citizens are children. 2 million new citizens will be ushered into the human race this year through Medicaid prenatal and obstetric coverage. 9 million blind and disabled citizens sleep easier each night thanks to the governors. Nearly a third of the states structure offerings through a managed care approach. All integrate physical and mental health, including addiction services.
Trump and his followers may be intent on creating chaos, promoting regressive legislation, and reimagining reality, but governors in most states are laser focused on solutions – and the more they experience single payer authority and efficiency, and benefit from integrated health planning, the more they and their citizens like it.
So it’s well to remember that it’s not whether you are for or against “Medicare-for-all” that matters. What really matters is that there be central oversight, uniform high standards, careful public health planning, integrated care, and – above all – that comprehensive health insurance be mandatory all-for-one and one “… FOR ALL” .
« go back — keep looking »
"Code Blue INDEX online"
Prospective Health Blog
BIOGRAPHY
Homegrown Friends
BIOGRAPHY
NIH Precision Medicine
BIOGRAPHY
Health in 30
BIOGRAPHY
Larry's Letters
BIOGRAPHY
Precision Medicine, Euthanasia, Abortion, Communism, Trillions of Dollars, Losing Freedom, and Town Hall Mobs BIOGRAPHY
Yearning for Universal Coverage Is Not Universal
BIOGRAPHY
