Now that we are in an Orwellian world in which words reflect corporate and politically motivated interests rather than reality, I thought that a glossary might helps many of us navigate the shark ridden waters of health reform.
HOW TO USE THIS TOOL
HEALTH CARE GLOSSARY
Politically Motivated Term
Politically Motivated Term
Politically Motivated Term
HOW TO USE THIS TOOL
Whenever one of the target words or phrases is used, simply reply by citing the information included under “reality based term”.
HEALTH CARE GLOSSARY
Politically Motivated Term
Death Panel: This term is used politically to scare us into thinking that if the “Obama” plan passes, Gestapo like panels of physicians will pull the plug on any patient (especially if they are old or disabled) with a poor prognosis.Reality Based Term
Death Panel: Death panels exist now, but not in Medicare and not at the VA. The only “Death Panels” that exist in the current health care system are in private health insurance plans, where a reviewer might deny a life saving service if it is deemed to be too expensive.
The so called “death panels” that are proposed under the Obama plan are really just a payment reform that would allow physicians to be paid for spending time with families and patients who are struggling to make difficult end of life decisions. I defy you to find A SINGLE PERSON who has not appreciated having a physician spend extra time with them during an episode of serious illness of a loved one.
Politically Motivated Term
Consumer Choice: This term is used politically to scare us into thinking that any type of health care reform will deny us of choice of doctor, drug, or treatment.Reality Based Term
Consumer Choice: Under our current system, for people who are uninsured or underinsured, consumer choice means the freedom to choose between getting treatment and going bankrupt OR delaying treatment and getting sicker or even dying (and then becoming bankrupt). The Institute of Medicine estimated that 18,000 people die each year related to lack of health insurance (IOM, 2001), a number that is estimated to be even higher today (Dorn, Urban Institute2008). Over half of all bankruptcies are related to medical bills (Himmelstein et al, American Journal of Medicine 2007). For those with insurance, consumer choice often means the choice of which for profit insurance company gets the right to deny your claims.
Politically Motivated Term
Government Run Health Care: This term is used politically to scare us into thinking that any type of health care reform will involve “Government bureaucrats” that will deny us of choice of doctor, drug, or treatment.Reality Based Term
Government Run Health Care: The VA is an example of government run health care, as is the military health care system. There is no mention anywhere in any of the current health reform proposals of anything like the VA. The “public option” would be an insurance plan that would compete with private insurers, similar to Medicare.
As long as we’re dealing with reality, how do these scary “government plans” compare to private?
The New England Journal of Medicine published a study that compared Veterans Affairs health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in Veterans Affairs facilities proved to be "significantly better"(Arsura et al. NEJM 2003). The Annals of Internal Medicine also published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care (Asch et al, Annals of Internal Medicine 2004). Scary, huh? For private insurers, its terrifying!
Here’s another scary statistic for insurers. In a recent study published in Health Affairs, guess what insurance was ranked most highly by enrollees? Medicare! In that study, 67% of elders rated Medicare as excellent or very good, 43% of Medicaid recipients rated their insurance as excellent or very good, and in last place only 21% of those with individual plans rated them as excellent or very good (Davis K et al. Health Affairs, July/August2009).
Politically Motivated Term
Socialized medicine: See government run health care, above.
Reality based Term
Socialized medicine: No such thing exists in reality.
Comments
“There is some fear because in the House bill, there is counseling for end-of-life, and from that standpoint, you have every right to fear. You shouldn't have counseling at the end of life. You ought to have counseling 20 years before you're going to die. You ought to plan these things out. And I don't have any problem with things like living wills. But they ought to be done within the family.”
What I am particularly amazed (and by amazed I mean DISTURBED) about is how two words can set back a movement that has made such progress over the past decade. The chasm between the politics of health care and what people actually need from their clinicians gets wider every day.
Five Things You Can Do About Healthcare, In Ascending Order of Difficulty and Commitment
Why aren't more people talking about health care as a civil rights issue? While arguably a problematic metaphor, for better or worse, primary and secondary education in this country are run on a "public plan". Those with resources who are dissatisfied still have the right to enter the marketplace using their own funds. In other countries, children whose families cannot afford school fees go without. Isn't free public school education akin to 'gasp' socialism? Isn't it time we had equality (and, I would hope improved quality) in health care too?
For instance - I put "We should incentivize end-of-life counseling" into the spin-o-matic this morning. Out popped the following:
"I'm no Washington insider but just a small town doc, but I'm fed up with big business insurance folks and government bureaucrats making decisions about my health care. It's time we take control of our health care decisions by giving you and your trusted doctor time to make medical decisions based on your values."
I've often wondered if palliative care talks too much about death. It's not that we shouldn't accept the mortality of all living things---but isn't palliative care really about life? Isn't the belief that all days of life have meaning---even the last days- a statement about the sanctity of life?
Palliative care and Geriatrics are the disciplines that care for patients that are often forgotten--including patients who can't be cured of their disease, but who have lost none of their value as human beings and deserve care that improves the quality of their lives. Palliative Care and Geriatrics are the ultimate life-affirming disciplines of medicine.