Saturday, May 05, 2007

More Murder by Spreadsheet

For lack of a dentist, a boy dies

Deamonte, died at the age of 12, Prince Georges County, Maryland:

Deamonte, a seventh grader in Prince George’s County, Maryland, just outside of Washington, D.C., died because he didn’t have health insurance to cover an $80 tooth extraction. The inexcusable loss of this 12-year-old’s life started when he complained of a toothache. His mother, Alyce, who works at low-paying jobs, didn’t have employer health insurance, and had been focused on finding a dentist to see Deamonte’s brother, who had six rotting teeth. Their Medicaid insurance coverage had been cut off, and Alyce’s efforts to renew the coverage were ensnarled in red tape and bureaucratic delays.

Here is Devante's tragic story.

Devante, died at the age of 14, Houston, Texas:
Devante was a 13-year-old boy with advanced cancer of the kidneys who went without any health coverage for four months while his mother attempted to renew his Medicaid coverage. Although his mother, Tamika, submitted at least three renewal applications beginning in February 2006—one through the financial counselor at Texas Children's Hospital—and called the CHIP/Medicaid hotline dozens of times, there was no record of Devante's case in the system when advocates contacted the call center on his behalf in August 2006. Because of a state staffing shortage, officials say his application went unprocessed.

Meanwhile, Devante went without any health insurance and had to depend on clinical trials for care as his tumors continued to grow.

Health protection yanked:

Jessica Bath claims Blue Shield scoured for reasons to drop her and her son because he needed costly care; the firm says mom left out medical issue on application

Four months after her first son, Jack, was born, Jessica Bath received a letter from her health insurance company, Blue Shield of California, saying she and Jack were no longer covered. Jack was born at Sierra Vista Regional Medical Center on April 8, 2003, with a hole in his heart. Bath was counting on Blue Shield to pay for a scheduled surgery to repair it.

Suddenly, both she and Jack were uninsured.

"It was absolutely devastating for us," Bath said. "How were we going to pay for his heart surgery?"


To understand the challenges of insuring the health of the nation’s work force, consider Varney’s Book Store.

A Portrait of the Working Insured After a long bout with emphysema an employee at Varney’s, a family-owned business in Manhattan, Kan., died several years ago. But for Varney’s health insurer, her legacy lived on.

The next year, 2002, the insurer raised Varney’s premiums by 28 percent — even though most of the other three dozen employees were significantly younger and healthier than their departed colleague, who had been in her mid-70’s. And Varney’s premiums continued to climb.

. . .Such are the challenges for smaller businesses in Kansas and the many other states where laws permit insurers to raise health premiums substantially for small employers when one worker incurs significant medical bills.

And it is why, as state legislatures, Congress and presidential candidates of all stripes debate the growing problem of Americans without health insurance, the struggles of small businesses — which employ about 40 percent of the nation’s work force — are likely to become a central issue. Small-business employees are one of the fastest-growing segments of the nation’s 44 million uninsured; they now represent at least 20 percent of the total, according to federal census data. And even modest-size employers like Varney’s that say they remain committed to providing benefits find themselves wondering how long they can continue.

Plights of uninsured stir efforts to sway lawmakers

WASHINGTON — Tamika Scott lost her 14-year-old son to cancer on March 1, less than a year after he lost his health insurance and was forced to go on clinical trials.

Within a month of his death, Scott was in the nation's capital telling her story to members of Congress. It was too late to help her son, Devante Johnson, but not the nation's 47 million uninsured, including 9 million children.

"When it touches home, everything changes," says Scott, 34, of Houston. "Then you're ready to change the world."

As Congress and state legislatures grapple this year with how to help the uninsured, lawmakers are increasingly hearing not only from lobbyists and health care advocates but from people who have suffered without insurance.

They are people like Alyce Driver of Maryland, whose 12-year-old son Deamonte died in February from an infection that spread from his tooth to his brain. People like Camilla Tecsy of New York, also 12, who lost health insurance for several months while battling cystic fibrosis. People like Mekeal Cusic of Mississippi, who couldn't get coverage for her 10-year-old daughter Keyonna because of intestinal problems suffered three years ago.

All have been to Washington this spring to personalize an otherwise complex financial issue. "There are heart-wrenching stories that really do rip your heart out," says Sen. Tom Carper, D-Del.

Can This Patient Be Saved?

As a surgeon, I’ve seen some pretty large tumors. I’ve excised fist-size thyroid cancers from people’s necks and abdominal masses bigger than your head. When I do, this is what almost invariably happens: the anesthesiologist puts the patient to sleep, the nurse unsnaps the gown, everyone takes a sharp breath, and someone blurts out, "How could someone let that thing get so huge?"

I try to describe how slowly and imperceptibly it grew. But staring at the beast it has become, no one buys the explanation. Even the patients are mystified. One day they looked in the mirror, they’ll say, and the mass seemed to have ballooned overnight. It hadn’t, of course. Usually, it’s been growing — and, worse, sometimes spreading — for years.

. . .It’s as true of societies as of individuals. We did not muster the will to reform our long-broken banking system, for example, until it actually collapsed in the Great Depression.

This is, in a nutshell, the trouble with our health care crisis. Our health care system has eroded badly, but it has not collapsed. So we do nothing.

Tuesday, May 01, 2007

The war for your electric bill

Stock analyst Jim Jubak, focusing on the effects of private-equity buyout funds, explains, "the last time Wall Street applied its best minds to the electric power industry, they brought us Enron, brownouts and wholesale-price-gouging in California, not to mention higher electric bills." Jubak points out that Wall Street investors raised $189 billion in 2006, and are headed for more than $250 billion this year, and with these funds, are buying out and privatizing public companies which supply energy to local communities. Companies like First Data, HCA, TXU Corp have all been privatized with this trend. Mirant, owner of 24 U.S. power generating plants is currently for sale and being targeted by the privatizers.

Jubak points to some likely results of this process.

And buyout funds are kicking the tires on other utilities. The buyout funds have lots of money to put to work, and utilities have the kind of big predictable cash flow that these funds like to see. This is bad, bad news for your utility bill in the short run. In the long run, it's even worse.

In the short run, making a profit on one of these buyout deals depends, first, on "restructuring" the company so that it's more profitable than it was before the buyout. Most of the time, restructuring involves spinning off money-losing operations and outsourcing some part of operations -- and it always involves cutting jobs.

That would be bad enough in the case of a utility, since job cuts are likely to mean a decline in utility service.

But you'll wind up paying more for less service because, second, turning those small gains in corporate profits into big profits for buyout investors rests on building the buyout deal so that borrowed money, known as leverage, multiplies those relatively modest improvements in corporate earnings.

In funding such privatizing investments, investors put up some cash, but borrow the rest by issuing debt backed by the assets of the acquired company. Jubak explains that, "in essence, the purchased company buys itself, but the buyout fund (and its investors) gets 100% of all future profits when the company is eventually sold back to the public." This is a shell game on a grand scale, but with an unwitting public as the dupes.

The debt load of these purchases also results in a reduced investment in new power lines and new power plants, all of which could benefit the consumer.


Need more?

Electricity consumers deserve better system

AP reporter Ryan Keith pointed out in his story that deregulation has not been successful in any of the 16 states, plus the District of Columbia, that have put it into place since the late 1990s. In fact, consumers in deregulated states pay more for electricity than those who stayed with regulating their power industries - about 30 percent more in 2006. And the gap continues to grow.

Consumers in all states are paying considerably more for electricity than a decade ago, primarily because of increases in the cost of fuel, primarily natural gas.

But that doesn't explain why deregulated states pay more for electricity than those in regulated states. What does seem to explain the situation is the lack of a competitive market.

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One thing is clear, however: Deregulation of electric utilities isn't working, and consumers are paying for it. That's a problem which needs a solution.