wnyc.org / 93.9fm / am 820

eva,
Agreed on all of it. I will check out the Kristoff column. I'm a big fan.

mc,
I agree - the approach to preventive care needs to be really broad. Did you see Kristof's article about nominating a food secretary today? It is free in the NYTimes.

I think we should have free fresh vegetable trucks in the inner city. It would not cost very much, compared to what we spend now on diabetes treatment. (Big pharma is smiling, even if I'm not.) The poor are the most hard-hit by type II diabetes and heart disease. It's always the poor. Also, non-northern European populations are more susceptible to Type II diabetes. That includes both groups I belong to...

I saw a recent study that suggested that obesity was exacerbated by a lack of exposure to certain nutrients. Really interesting. I will try to dig it up. Vis-a-vis the ineffectual treatment you mentioned, there was a study released this fall that suggested that knee surgery isn't any more effective than non-invasive and far less costly approaches.

Most doctors I know would, seriously, prefer to have a healthy population. The system just isn't geared for it. We need to change this.

eva,
It is interesting to look at why the obesity etc., cost states so much money. In addition to not preventing the diseases in the first place, we spend gobs of money on unproven and often ineffective care for the conditions.

AWM is right, Obama prominently mentioned wellness in the press conference. We need to get more serious about this. Why is soda less expensive than bottled water? Answer: High frucose corn syrup, which is subsidized like all corn products. Of course, you shouldn't really be buying bottled water, but there it is.

mc, I agree that you're not going to immediately mitigate health care inflation through wellness.
Longterm, I think we both agree that preventing Type II diabetes and heart disease is essential to resuscitating state budgets.
In 2005, State of California spent 23.7 Billion, (that's billion, with a B!), on overweight and obesity related illness - totally preventable. I'd like to see that money go into math and science education and - mush less costly - healthy food programs. I know you would, too. Meantime, we have to take care of the people who got sick while our health care system was asleep at the wheel.

AWM, thanks for pointing out the preventive health care mention in the press conference. I am going to relisten to it ASAP.

AWM:
G;ad you did not see it as a complaint. I take very seriously our responsibility to keep people aware of the fact that we are not done by any means, just because we are happy with the outcome of the election. I want Obama to be successful in reforming health care. But I will continue to press the issue of runaway costs because we cannot do anything meaningful until we take that part seriously. Not nearly enough people are talking about it. I intend to go right on talking and talking about it. Maybe in my small way I can help prepare people for the very uncomfortable and difficult conversation we need to have. I do not want this to bite the new administration because they did not take it seriously enough and did not mention it enough to the people.

Hi eva,
I may have included myself erroneously in a collective "you all," in your earlier post. Phonebanking wasn't the only activity, I also wrote an article for my union paper comparing the McCain and Obama health plans. It was not a Democratic screed (in spite of what my leadership wanted me to write) but I was able to point out how the McCain plan took us even further in the wrong direction.

As far as the wellness aspect and its effect on health care costs, I think it is very important to stress wellness because it will make us healthier and that should be everyone's goal. But the evidence that it will bring down the galloping 6-12% health care inflation is just not there.

mc,

Didn't say that you specifically are complaining and didn't see your post as a complaint. I thought it was informed and honest. I'm irked by the premature complaining and feel the need to point it out from time to time.

In my post I referred to the fact that in the press conference, Obama said that he would try to streamline IT and focus on preventative care as a way to save money, it is an initial step taken in a situation where actual resources are scarce and otherwise allocated to softening each unprecedented blow to our economy, two wars and whatever else escapes my catastrophe-fatigued mind.

As for political capital, the healthcare burden has a detrimental effect on businesses and people are being laid off at historical levels leaving them uninsured. I think, like the word “deficit”, political capital will be trumped by the severity and urgency of the problems we face. That is, if the next administration moves swiftly, wisely and efficiently to address these problems. I guess that’s where “hope” comes in. If it’s just more of the same it will become apparent quickly and we’ll be in a heap o’ trouble.

Hi mc,
Are you sure I said that? I'm sorry if I did. I was VERY glad (but not surprised) to learn that, after the primary, you were volunteering and phone banking for Obama. I would have done the same for HRC. I do remember writing to hjs and seth that they gave me only a lukewarm response on phonebanking, but I think I also wrote that they voted, and that's what counts.

Anyway, I'm glad you're asking questions. I understand how AWM feels, too. It's like: we have to give this guy a chance.

I think a lot of the appointments are very exciting. I hope they are also effective, we're in an awful bind in this country.
I agree with virtually everything in your last paragraph, except I disagree about its having an effect right now. It can boost productivity, which is not specifically health care related, but does affect our overall GDP.

eva,
Glad to see you are back. I was wondering if you lost interest after the election. I must admit being a bit miffed at your assumption a couple of weeks ago that I had not worked for the outcome of that election. As I had mentioned some time earlier, my union hosted phone banks for several weeks before Nov. 4. We called union members in FL and PA. We also worked for some key NY area candidates.

I agree with you about preventive care. The current structure as it is set up leaves no incentive for providers to specialize in preventive care. All the money is thrown at treatments once a situation becomes dire. Or it is wasted on inconclusive CT scans and the like. We do need to cultivate a better wellness culture for our own health, however, that will not save significantly on what we pay out now.

AWM:

"Really?" Don't know what you mean by that. I asked a question.

I am not complaining about the next administration. I am agitating for a discussion about the hard subject of health care costs. It is not being addressed in a real way. If we don't prepare the people for that discussion, the costs will blindside us all and we will as I said above run out of political capital.

mc,

Really?

Healthcare, the economy, Iraq, Afghanistan, etc.

All of the incredibly difficult "things" that have to be dealt with.

So many people are complaining about how the next administration will deal with these "things" before the next administration can actually deal with them or has dealt with them.

Why aren't we talking about preventive care? This would save an obscene amount of money that is currently being flushed down the toilet - which means we can't properly fund the treatment of non-preventable illness.
Why aren't we engaging the public in helping them to take care of themselves so we can fund the treatment of non-preventable illness?
I am shocked this is not being discussed. It is so obvious. But I was not able to listen to the entire speech. Did I miss something? or is it just being, again, ignored?
Preventive care is a win-win. Please!
The ultimate irony is people having to keep a miserable job that encourages poor health habits - only so they can maintain health insurance which 1) can't fix them and 2) has a bad habit of denying their claims.

AWM:

What "things?"

mc,

Can we please let them start to try to deal with these things before we compare them with efforts that were made a decade and a half ago?

Tom:

I believe the AMA has taken an official stance in favor of universal coverage, whatever that means and belated as it is.

AWM:
There is no evidence that "streamlining IT" will save any substantial costs. If we don't find a way to adequately fund this as well as reining in costs we will run out of political capital so fast it will make '93 look like a pleasant tea party. Remember, 48 million sounds like a lot of people. It is. It is also only 15% of the population.

Amazing.

Please, be honest.

You speak of campaign promises as if we live in a vacuum. The landscape is changing rapidly here and abroad.

He is trying to change the healthcare system in the midst of the worst economic crisis of our lifetimes.

He stated that he will START by streamlining IT and other measures that will increase savings which is what you have to do when resources are scarce and growing more scarce. In addition, an immediate rescinding of the Bush tax cuts would be devastating in this environment.

Is there any way of finding out when exactly any health reform plan would take effect? How many years? For many people, now more than ever (including yours truly), I don't think relief from the current system can come fast enough.

Thank you for pointing out that there is no real cost control here. IT will likely improve service and safety but there is scant evidence that it will save a lot of money. 31% of our health care costs are eaten up in hospitals now according to CMS. How 'bout that?

Unbelievable!

President-Elect Obama just introduced his health care team and is talking about finally moving our draconian health care system into the new century--which will cover all the laid off people in our new depression, and all the media cares about is a hack governor that, it has been shown, has absolutely no connection to Mr. Obama or anyone on his team.

The media leads the way in forcing the masses not to pay attention to what's really important! Eyes on the prize, people. Eyes on the prize.

See which states have the best healthcare coverage and build off their plans. Or just lock Gov. Mitt Romeny (MA) and Dr. Howard Dean (VT) in a room for one week and have them come up with a plan.