When Insurers Put Profits Before People

NYTimes.com: How an insurance company let a teenager die, then spared no expense to save itself.

Book Review:T. R. Reid’s "The Healing of America"

For people like me, who see universal coverage as a moral and economic imperative, and who think nuance, detail, and pragmatics matter, T. R. Reid’s "the Healing of America" is required reading, imo. In analyzing the different health systems of the world, Reid digs below the rhetoric and into the substance. In the process, he obliterates common myths held by Americans about other delivery systems, while also showing that all models carry unique problems. The big takeaway is that the U.S. should learn from this reality and adopt an approach that’s consistent with our needs.

So it’s clear there’s a lot of variety out there, and the blanket "socialist" label neglects the fact that typical systems include a mix of public and private entities. Further, we shouldn’t arrogantly assume that nothing works in other countries; the truth is that other industrialized systems cover everybody for much less than we spend, and their populations are healthier overall as a result. That doesn’t mean the U.S. should emulate entire frameworks -- it’s more that we should learn about what works, and make smart decisions here with that knowledge.

For instance, we spend 30 for 40% on healthcare administration, while France and Taiwan keep it near 5%, largely through standardized electronic record-keeping and "smart" cards that centralize patient history. Why wouldn't we want to mimic that (assuming privacy is protected)? Great Britain religiously focuses on prevention to keep costs down. Why shouldn't we create a public option based on the "medical home" model to do the same (rewarding quality, not quantity and churn)? If it works -- there are already smaller-scale success stories in the U.S. -- Medicare will also adopt it, generating massive cost savings. And private insurers might follow suit as well.

Read the entire review here.

Hidden costs, value lost: uninsurance in America

Google Book Search:
By Institute of Medicine (U.S.). Committee on the Consequences of Uninsurance"

Hidden Cost, Value Lost, the fifth of a series of six books on the consequences of uninsurance in the United States, illustrates some of the economic and social losses to the country when maintaining so many people without health insurance. The book explores the potential economic and societal benefits that could be realized if everyone had health insurance on a continuous basis, as people over age 65 currently do with Medicare. 'Hidden Costs, Value Lost concludes that the estimated benefits across society gained by providing the uninsured with the kind and amount of health services that the insured use, are likely greater than the additional social costs of doing so. The potential economic value to be gained in better health outcomes from uninterrupted coverage for all Americans is estimated to be between $65 and $130 billion each year.

Conflict Over Spying Led White House to Brink - washingtonpost.com

This is the first of two stories adapted from "Angler: The Cheney Vice Presidency," to be published Tuesday by Penguin Press.

"Cheney and his counsel would struggle for months to quash the legal insurgency. By the time President Bush became aware of it, his No. 2 had stoked dissent into flat-out rebellion. The president would face a dilemma, and the presidency itself a historic test. Cheney would come close to leading them off a cliff, man and office both"