Posts tagged with: health care

bribeIt is no secret that rule of law in places like Slovakia is weak. Corruption, pay-offs, bribes and twisted use of power often pass for “rule of law.” However, this problem has infected  health care as well, which means those who are able to bribe the doctor or health care worker is the one who will get the care.

The Economist describes Communist-era corruption as a holdover infesting much of central and eastern Europe, and not just in health care. However, it’s one thing to bribe an official to get a building permit; it’s quite another to have to do it for live-saving surgery.

In Latvia Valdis Zatlers, an orthopaedic surgeon who served as the country’s president from 2007 to 2011, accepted what he called “gratitude payments” from patients without declaring them to the tax authorities. He was fined just 250 lats ($466). A European Commission survey in 2013 found 28% of respondents in Romania and 21% in Lithuania had made informal payments to doctors, compared to an EU average of 5%. (more…)

Dr. Kent Brantly

Dr. Kent Brantly

I once read a fascinating book about the leper colony on Molokai. The Molokai lepers were literally cast out of society, sent as far away as possible, with almost no support systems.  There was no health care for them, no houses beyond rudimentary shelter, no way to readily obtain clothing, school books for children…it was a frightful and frightening situation. A brave and gentle priest, Fr. Damien de Veuster from Belgium, accepted the assignment to go to Molokai and serve the 600 lepers there.

He arrived to chaos. Those suffering from leprosy were living in a lawless society. They fought over food, areas of land – it was survival of the fittest. In the 16 years that Damien lived on Molokai, he built a church, helped the people build houses that truly were homes, constructed needed buildings and roadways in the mountainous region, taught farming to the residents, and provided education. His greatest gift, however, was spiritual. (more…)

Blog author: ehilton
Wednesday, April 9, 2014

uncle sam life supportAmerica has been underwhelmed by Obamacare. Beyond the website glitches and stories of waiting for hours to sign up, we can start assessing the actual program.

An April 8 Rasmussen poll finds only 23 percent of Americans call Obamacare a “success,” and 64 percent believe it will be repealed. the White House is in a tough spot; the program was built with the understanding that young people would flock to it, eager to snap up inexpensive health care plans. These purchases would help pay for the less-healthy and older enrollees. Young people would be paying their premiums, but since they don’t get sick as often, that money would be used for those who are typically less healthy. Those signing up, though, are tending to be older and sicker than expected:

People who signed up early for insurance through the new marketplaces were more likely to be prescribed drugs to treat pain, depression and H.I.V. and were less likely to need contraceptives, according to a new study that provides a much-anticipated look at the population that signed up for coverage under the new health care law.

The health of those who enrolled in new coverage is being closely watched because many observers have questioned whether the new marketplaces would attract a large share of sick people, which could lead to higher premiums and ultimately doom the new law.


church busImages of Mississippi needing federal assistance are iconic. Robert F. Kennedy’s 1967 trip to Mississippi’s Delta region produced images of poverty not unlike LBJ’s War on Poverty tour. Jennifer Haberkorn has written a piece at Politico titled, “Obamacare enrollment rides a bus into the Mississippi Delta.” Her snooty lede to the story reads: “In the poorest state in the nation, where supper is fried, bars allow smoking, chronic disease is rampant and doctors are hard to come by, Obamacare rolls into town in a lime green bus.”

It appears the author believes Obamacare could bring the good news of salvation if only Mississippians skeptical of the federal government would let it. Haberkorn writes:

The effort in Mississippi illustrates the obstacles the health law must overcome in many parts of the country, particularly in deeply conservative areas where antipathy toward Washington mixes with challenges of geography, education and general skepticism or ignorance of the Affordable Care Act. High rates of poverty and disease — which mark much of this state — don’t necessarily aid recruitment. Add the strident opposition of GOP leaders and enrollment gets that much tougher.

Haberkorn cherry picks a couple of positive stories where heavily subsidized consumers will save money under the Obamacare program, but totally ignores a major component of all the skepticism with the plan. Obamacare premiums in Mississippi are the third highest in the nation, only surpassed by Alaska and Wyoming. As of September 2013, a mid range plan cost $448 monthly, with costs expected to rise. (more…)

A new study by Grand Valley State University professors Leslie Muller and Paul Isely suggests that the Affordable Care Act has already cost West Michigan 1000 jobs. Muller summarized the results in a Wood TV story:

“Firms are actually holding off on hiring or their reducing their hiring that they were thinking they were going to be doing because of the ACA,” said Muller.

The 1,000 jobs lost does not include the number of workers in West Michigan that have lost hours to ensure that they are kept as part-time employees. Nearly one-third of companies said they have cut employees’ hours.

“We’re talking about a thousand jobs in West Michigan that would have been here absent the ACA,” Muller said.

The study found lower-skilled jobs tend to be suffering the most.


In my blog post yesterday about our statist healthcare system and the need for more economic freedom, I referenced a NYT piece by Scott Gottleib and Zeke Emmanuel and argued that if their rosy view of America’s healthcare future has any chance of coming true, we’ll need far more economic freedom in the system than currently exists. Now Greg Scandlen has a sobering essay at the Federalist challenging the NYT piece, taking particular issue with their pointing to Massachusetts as a hopeful model and for suggesting that nurse practitioners will help make up the difference once Obamacare starts driving up demand for healthcare services.

Gottleib’s and Emmanuel’s argument had other elements, including a call for increased economic freedom for the healthcare industry, but on the Massachusetts point, Scandlen’s response appears devastating. In a nutshell, he notes that Massachusetts passed Obamacare-style reforms beginning seven years ago and now has much longer appointment waiting times than the rest of the country, despite having far more physicians per capita than the national average. Read the piece and the helpful data tables here.

In today’s Acton Commentary I explore how our hyper-regulated and increasingly statist healthcare system is chasing off good physicians.

A recent article in Forbes by Bruce Japsen provides some additional support for that argument:

Doctor and nurse vacancies are approaching nearly 20 percent at hospitals as these facilities prepare to be inundated by millions of patients who have the ability to pay for medical care thanks to the Affordable Care Act.

A survey by health care provider staffing firm AMN Healthcare shows the vacancy rate for physicians at hospitals near 18 percent in 2013 while the nurse vacancy rate is 17 percent. That vacancy rate is more than three times what it was just four years ago when vacancies for nurses were just 5.5 percent in 2009 while vacancies for doctors were 10.7 percent.

It’s not all doom and gloom. In an earlier Forbes piece, Scott Gottlieb, an internist and fellow at the American Enterprise Institute, argues that technological and organizational innovation will allow quality health care to be delivered using fewer physicians.

If allowed to proceed, these innovations may actually increase market freedom in one area. Physician organizations and medical schools often have replicated a pernicious feature of the traditional guild, namely, finding ways to limit the number of new physicians not purely as a quality control measure but, beyond this, as a way to ensure that existing physicians are in high demand. (more…)