Another comment on a previous topic: Bill Richardson's presidential health care plan. I came across a report that said he also supported the idea of giving parity to mental health coverage in his universal health care plan. This is a bipartisan concept that long has been pushed by New Mexico's Republican Sen. Pete Domenici.
Meanwhile, back at home, the ACLU has a court case that has delayed implementation of some program cuts by ValueOptions, the state's contractor for government-supported mental health services. The company rightly points out that its contract doesn't require provision of those services and it no longer can afford to support them. And Richardson did ask for more money in the next state budget to pay for them, but he didn't push for the funding again in the special session after lawmakers didn't approve the money in the regular session.
New Mexico has gotten lots of national attention for its effort to centralize state-provided mental health services through one contract. It is an innovative attempt to streamline and standardize services, getting more bang for the buck.
But that's the point. Critics have noted that Richardson wants to get credit for making improvements without having to put more money into mental health services. Some additional has been provided, in dribs and drabs, most notedly for autism in the most recent session. I don't know if that's enough to bring New Mexico up from dead last in its ranking among states for spending on mental health.
During his tenure, there has been enough money, apparently, for spaceports and trains and tax cuts.
Friday, March 30, 2007
Chemicals Blamed for Fat
The bottom line on obesity, people tell us, is that we get fat because we take in more calories than we burn. Pretty basic. Hard to argue with it. But yesterday I came across a story in the Washington Post Weekly (March 19-25) that says chemicals in our environment might have something to do with the nation's obesity epidemic.
This struck my attention since I read it not long after my previous post on questions about chemicals. The story, by Elizabeth Grossman, looks at various chemicals, often called "endocrine disprupters," that can have hormone-like effects. The chemicals, present in products such as plastics and fungicides, supposedly increase the number of fat cells, which in turn send out signals of hunger, which cause people to eat more.
The effects supposedly can be launched in utero, so a baby is born with the predilection for greater fat cell activity. Studies have been done only in animals such as mice so far. Interesting, but not proven.
This struck my attention since I read it not long after my previous post on questions about chemicals. The story, by Elizabeth Grossman, looks at various chemicals, often called "endocrine disprupters," that can have hormone-like effects. The chemicals, present in products such as plastics and fungicides, supposedly increase the number of fat cells, which in turn send out signals of hunger, which cause people to eat more.
The effects supposedly can be launched in utero, so a baby is born with the predilection for greater fat cell activity. Studies have been done only in animals such as mice so far. Interesting, but not proven.
Wednesday, March 28, 2007
A Beef With Hormones
News (http://www.sciam.com/article.cfm?chanID=sa003&articleID=9FB640EA6ABE0E849C8C1FD6EEA97C22) linking mothers' consumption of beef with low sperm count in their sons caught my attention. Like all studies, it isn't conclusive -- but it raises interesting questions. The theory is that women in the U.S., when they eat beef, ingest a number of hormones used in that beef to spur growth and health. Among them are sex hormones, such as estrogen. Those hormones then can interact with the growth of a fetus in their womb, somehow disrupting its own development. In this case, low sperm counts.
Similar questions have been raised about hormones we all end up eating in our food or drinking in our water -- some plastics have estrogen-like chemicals that may affect our bodies.
And all of this has me wondering about what subtle effects may occur from any number of chemicals piling up in our environment, whether we breathe, eat or drink them. Pesticides, heavy metals, hormone-like substances, nanoparticles -- you name it. I used to think of people who obsessed about such things as being alarmists, but now I'm not so sure.
The problem is that it's very hard to trace subtle effects that occur over a long period of time. Science is relatively good at measuring acute effects: we give the mouse a certain amount of a chemical and it dies. OK, that's bad. Our safe level of exposures to many contaminants are often based on those types of studies. Granted, in the interests of safety, the accepted levels of those contaminants are set at proportionate numbers many times lower than the fatal toxic level.
But how about those subtle effects? Where low-level exposures may grow over time? Or, even trickier, where (1) a low-level exposure to a pregnant woman may (2) affect the expression of certain genes or development of the fetus in a way that, (3) partly because of the genes it inherited in the first place, (4) may cause the person that fetus becomes to suffer harm when then exposed to yet another, or more of the same, substance or germ in its environment as a child and adult.
That becomes waaaaay harder to trace in a study. And makes me think that an organic, natural lifestyle may be more important than we think -- both to us and to our planet.
Of course, the good news may be that really subtle effects may take such a long time to develop that we'll die of something else first anyway. Things we deliberately do to ourselves, like sucking on cigarettes or parking our butts in front of the TV.
Similar questions have been raised about hormones we all end up eating in our food or drinking in our water -- some plastics have estrogen-like chemicals that may affect our bodies.
And all of this has me wondering about what subtle effects may occur from any number of chemicals piling up in our environment, whether we breathe, eat or drink them. Pesticides, heavy metals, hormone-like substances, nanoparticles -- you name it. I used to think of people who obsessed about such things as being alarmists, but now I'm not so sure.
The problem is that it's very hard to trace subtle effects that occur over a long period of time. Science is relatively good at measuring acute effects: we give the mouse a certain amount of a chemical and it dies. OK, that's bad. Our safe level of exposures to many contaminants are often based on those types of studies. Granted, in the interests of safety, the accepted levels of those contaminants are set at proportionate numbers many times lower than the fatal toxic level.
But how about those subtle effects? Where low-level exposures may grow over time? Or, even trickier, where (1) a low-level exposure to a pregnant woman may (2) affect the expression of certain genes or development of the fetus in a way that, (3) partly because of the genes it inherited in the first place, (4) may cause the person that fetus becomes to suffer harm when then exposed to yet another, or more of the same, substance or germ in its environment as a child and adult.
That becomes waaaaay harder to trace in a study. And makes me think that an organic, natural lifestyle may be more important than we think -- both to us and to our planet.
Of course, the good news may be that really subtle effects may take such a long time to develop that we'll die of something else first anyway. Things we deliberately do to ourselves, like sucking on cigarettes or parking our butts in front of the TV.
Monday, March 26, 2007
Universal Health Care
Reading the news yesterday, I came across an item that said presidential candidate and New Mexico Gov. Bill Richardson said he could create universal health care in this country -- during his first year in office! Since he's in his sixth year as chief executive of New Mexico, with a Democratic majority in both the House and Senate, and hasn't created universal health care here yet for some two million people, I was fascinated to learn the details.
The most authoritative and complete (I use that word advisedly) explanation I could find was on the Richardson for President web site: http://richardsonforpresident.com/blog/seiu2.
The guts of it appears to be to allow people 55 and older to buy into Medicare and to allow "working families" (how about working singles?) to buy into "the same plan members of Congress enjoy." Well, I've read lots of references to candidates vowing Americans will get the same kind of health care available to members of Congress. But it occurred to me that I didn't know what that congressional health plan was. So I did a little Googling and found that members of Congress can buy into the federal employees health plan -- which gives several choices of insurers and plans, which vary from state to state. So I'm afraid I can't give you any set guaranteed benefits and premium costs.
Of course, it occurs to me that, in order to enjoy exactly the same kind of health care members of Congress get, we'd all have to be given six-figure incomes and the clout that comes from voting on matters dear to the hearts of the people providing that health care.
But never mind that. It's true, the opportunity to buy into a large health plan would make health insurance more affordable to many people. There are questions, though. If you're self-employed, do you pay only the employee portion of the premium or the entire portion? And some people already have health coverage available at work, but choose not to get it because they don't feel they can afford even the portion of the premium that comes out of their pay now. And how about unemployed people? Or people who lose their jobs because of ill health, no longer have income coming in, and are faced with mounting medical costs that aren't covered by their insurance? Which do they pay first: their co-pays or the premiums to ensure they get continued coverage?
Well, there's a simple answer in Richardson's health plan to make sure everyone gets covered: Pass a law requiring everyone to get health insurance. Just like auto insurance is required by law. And we know there are no uninsured drivers on our roads. Right?
This proposal -- not all that different, by the way, from those I've seen proposed by other candidates -- seems to stem from efforts in Massachusetts to provide universal coverage. That state requires everyone to have health insurance. I tried to find out how well that is working, only to discover that requirement won't take effect until July 1. The penalty for not having health insurance is $200 in tax penalties next year, and an amount equal to half of a year's premium cost of the most affordable plan. (http://amednews.com, 4/2/07)
But how do you enforce it? With auto insurance, at least there's some pretense of checking to see if you have insurance when you renew your license or auto registration. How do you do it with health insurance? Check for coverage when you go to get health care and then refuse it if a person doesn't have insurance? Wait a minute... that's how the current system works.
OK. Suppose you build in help to make this affordable for everyone. What will that cost and where will the money to fund it come from? Candidate John Edwards has estimated providing coverage for folks without health insurance now would cost about $120 billion/year. That would be paid for through revoking tax cuts that people making more than $200,000 have gotten in recent years, Edwards said. (Bloomberg News, 3/26)
I haven't found any price tag provided by Richardson.
But I've seen news reports in which he claimed universal coverage could be funded by money now spent on the war in Iraq. That assumes, of course, he'd substantially reduce money spent on troops in Iraq, or pull them out completely. It also implies something else. Federal budget deficits have been growing under the current administration, at least partly due to spending on the military and tax cuts given under the Bush administration. So if Richardson plans to use money now spent on Iraq for health care, that suggests he would continue the same level of deficit spending.
The only alternatives to continuing deficits, it seems, would be to (a) increase taxes, or (b) cut spending elsewhere.
I also read a vague reference that Richardson would cut administrative costs to help pay for the additional coverage. Hard to imagine how he could do that with the current system. Even if the federal health plan had contract requirements that only a certain percentage of the money could be used on administrative costs, that doesn't touch the administrative costs suffered by health providers who have to keep hiring more people to manage all the paperwork generated by a plethora of health plans.
Of course, using the current system is politically attractive because it would generate less opposition from insurance companies and others who make a profit from the current system.
So, explain to me again how he hasn't managed to put such a system into place in New Mexico, substituting the state employee health coverage for the federal plan that people could buy into?
Yet he could do it on the federal level within a year?
The most authoritative and complete (I use that word advisedly) explanation I could find was on the Richardson for President web site: http://richardsonforpresident.com/blog/seiu2.
The guts of it appears to be to allow people 55 and older to buy into Medicare and to allow "working families" (how about working singles?) to buy into "the same plan members of Congress enjoy." Well, I've read lots of references to candidates vowing Americans will get the same kind of health care available to members of Congress. But it occurred to me that I didn't know what that congressional health plan was. So I did a little Googling and found that members of Congress can buy into the federal employees health plan -- which gives several choices of insurers and plans, which vary from state to state. So I'm afraid I can't give you any set guaranteed benefits and premium costs.
Of course, it occurs to me that, in order to enjoy exactly the same kind of health care members of Congress get, we'd all have to be given six-figure incomes and the clout that comes from voting on matters dear to the hearts of the people providing that health care.
But never mind that. It's true, the opportunity to buy into a large health plan would make health insurance more affordable to many people. There are questions, though. If you're self-employed, do you pay only the employee portion of the premium or the entire portion? And some people already have health coverage available at work, but choose not to get it because they don't feel they can afford even the portion of the premium that comes out of their pay now. And how about unemployed people? Or people who lose their jobs because of ill health, no longer have income coming in, and are faced with mounting medical costs that aren't covered by their insurance? Which do they pay first: their co-pays or the premiums to ensure they get continued coverage?
Well, there's a simple answer in Richardson's health plan to make sure everyone gets covered: Pass a law requiring everyone to get health insurance. Just like auto insurance is required by law. And we know there are no uninsured drivers on our roads. Right?
This proposal -- not all that different, by the way, from those I've seen proposed by other candidates -- seems to stem from efforts in Massachusetts to provide universal coverage. That state requires everyone to have health insurance. I tried to find out how well that is working, only to discover that requirement won't take effect until July 1. The penalty for not having health insurance is $200 in tax penalties next year, and an amount equal to half of a year's premium cost of the most affordable plan. (http://amednews.com, 4/2/07)
But how do you enforce it? With auto insurance, at least there's some pretense of checking to see if you have insurance when you renew your license or auto registration. How do you do it with health insurance? Check for coverage when you go to get health care and then refuse it if a person doesn't have insurance? Wait a minute... that's how the current system works.
OK. Suppose you build in help to make this affordable for everyone. What will that cost and where will the money to fund it come from? Candidate John Edwards has estimated providing coverage for folks without health insurance now would cost about $120 billion/year. That would be paid for through revoking tax cuts that people making more than $200,000 have gotten in recent years, Edwards said. (Bloomberg News, 3/26)
I haven't found any price tag provided by Richardson.
But I've seen news reports in which he claimed universal coverage could be funded by money now spent on the war in Iraq. That assumes, of course, he'd substantially reduce money spent on troops in Iraq, or pull them out completely. It also implies something else. Federal budget deficits have been growing under the current administration, at least partly due to spending on the military and tax cuts given under the Bush administration. So if Richardson plans to use money now spent on Iraq for health care, that suggests he would continue the same level of deficit spending.
The only alternatives to continuing deficits, it seems, would be to (a) increase taxes, or (b) cut spending elsewhere.
I also read a vague reference that Richardson would cut administrative costs to help pay for the additional coverage. Hard to imagine how he could do that with the current system. Even if the federal health plan had contract requirements that only a certain percentage of the money could be used on administrative costs, that doesn't touch the administrative costs suffered by health providers who have to keep hiring more people to manage all the paperwork generated by a plethora of health plans.
Of course, using the current system is politically attractive because it would generate less opposition from insurance companies and others who make a profit from the current system.
So, explain to me again how he hasn't managed to put such a system into place in New Mexico, substituting the state employee health coverage for the federal plan that people could buy into?
Yet he could do it on the federal level within a year?
Subscribe to:
Posts (Atom)