Op-Ed

To Save Billions, the Government Should Pay Doctors to Make House Calls

Dr. Bruce Kinosian still makes house calls, and he's proud of it. In fact, he introduces himself as a physician who goes to see his patients in their homes rather than insisting that they come to see him at his office.

He's convinced that if more doctors did what he does, we could eliminate billions of dollars we currently spend in this country in an often-futile -- and almost always incredibly expensive -- effort to get people well.

Much of that savings, he says, would accrue to the Medicare program, making it unnecessary for Congress to even consider eliminating benefits or raising the eligibility age.

Kinosian, associate professor of medicine at the Hospital of the University of Pennsylvania in Philadelphia, is a leading advocate of the Independence at Home (IAH) program, which quietly has been saving the Department of Veteran's Affairs (and taxpayers) lots of money -- and improving the quality of life for thousands of veterans -- for nearly three decades.

Do We Really Need Insurers in Primary Care?

For health insurance executives, there is no scarier word than disintermediation. It's a fancy word that means eliminating the middleman, and those executives know that to many folks, they are the middlemen who all too often stand between patients and their doctors.

Now a small but growing number of doctors are figuring out that they and their patients can do quite well without the middleman. If this nascent trend catches on, insurance executives might soon discover that they have been disintermediated, at least as far as the delivery of primary care is concerned.

ALEC Exposed: Protecting Factory Farms and Sewage Sludge?

As suburbs engulfed the rural landscape in the boom following World War II, many family farmers found themselves with new neighbors who were annoyed by the sound of crowing roosters, the smell of animal manure, or the rumble of farming equipment. In defense of family farming, Massachusetts passed the first "Right to Farm" law in 1979, to protect these farmers against their new suburban neighbors filing illegitimate nuisance lawsuits against them when, in fact, the farms were there first. Since then, every state has passed some kind of protection for family farms, which are pillars of our communities and the backbone of a sensible system of sustainable agriculture.

Money Still Owed In Federal Bailout: $1.5 Trillion Still Owed to Treasury, Federal Reserve

  • Topics: Banking
  • A new study released today by the Center for Media and Democracy (CMD) shows that, despite rosy statements about the bailout's impending successful conclusion from federal government officials, $1.5 trillion of the $4.8 trillion in federal bailout funds are still outstanding.

    The analysis, presented in charts and an online table and program profiles, is based entirely on government records. This comprehensive assessment of the bailout goes beyond the relatively small Troubled Asset Relief Program (TARP) program to look at the rest of the Treasury and Federal Reserve's multi-trillion dollar response to the financial crisis. It shows that while the TARP bailout of Wall Street (not including the bailout of the auto industry) amounted to $330 billion, the government also quietly spent $4.4 trillion more in efforts to stave off the collapse of the financial and mortgage lending sectors. The majority of these funds ($3.9 trillion) came from the Federal Reserve, which undertook the actions citing an obscure section of its charter.

    Health Insurers Sacrifice Americans for Profit

    Three of the biggest health insurers have announced quarterly earnings in the past few days. If Americans were able to eavesdrop on what executives from those firms tell their Wall Street masters every three months, they would have a better understanding of why premiums keep going up while the number of people with medical coverage keeps going down.

    It only takes three words, when you get right down to it, to describe the real of those folks: profits over people.

    CIGNA and Humana are scheduled to report earnings this week. The three companies that have already spoken -- UnitedHealth, WellPoint and Aetna -- earned a combined $2.51 billion from April through the end of June, more than analysts expected. On a per share basis, their earnings were up more than 17 percent on average compared with the second quarter of 2010.

    A Smart Investment in Our Kid's Health

    If opponents of health care reform could view the grant money in the Affordable Care Act as an investment in our children rather than wasteful spending, I believe at least some of them would eventually accept that we're better off with the law than without it.

    I'd be especially confident if they took the time to visit some of the community facilities that will be able to meet the health care needs of thousands more Americans as a result of those grants.

    Earlier this month, the Obama administration announced awards of $95 million to 278 school-based health center programs across the country. The grants -- the first of $200 million worth of awards between now and 2013 -- will help clinics expand and provide more medical services at schools nationwide.

    3 Tips on Exposing ALEC's Influence in Your State

    (Editor's note: The Center is deeply grateful for all the research into ALEC politicians underway, especially by Daily KOS bloggers, and we are offering the tips today in light of the many questions people have asked about how to help with this research.) The Center for Media and Democracy recently unveiled a trove of "model" bills voted on behind closed doors by corporations and politicians through the American Legislative Exchange Council (ALEC). Many of these bills and provisions have been introduced in state houses across the country without any mention of the ALEC connection and have become legally binding. In addition to the analysis of the more than 800 pieces legislation on "ALECexposed," CMD released a list of lawmakers from across the U.S. who serve as ALEC "Chairmen" in each state.

    Consumer Bureau Launches in Shark-Infested Waters

    The Consumer Financial Protection Bureau (CFPB) throws open its doors to consumers this week, officially starting its mission to safeguard Americans from overly complex financial products and malignant banking practices. The bureau is the culmination of a national grassroots effort to hold the big banks accountable for the 2008 economic collapse caused by Wall Street's insatiable appetite for dangerous mortgage products. Millions of Americans signed petitions to create the bureau and new polling shows that 74% of Americans think it is a terrific idea.

    ALEC Exposed: Milton Friedman's Little Shop of Horrors

    Although he passed away in 2006, states are now grappling with many of the toxic notions left behind by University of Chicago economist, Milton Friedman.

    In her groundbreaking book, The Shock Doctrine, Naomi Klein coined the term "disaster capitalism" for the rapid-fire, corporate re-engineering of societies still reeling from shock. The master of disaster? Privatization and free market guru Milton Friedman. Friedman advised governments in economic crisis to follow strict austerity measures, combining radical cuts in social services with the full-scale privatization of their more lucrative assets. Many countries in Latin America auctioned off everything standing -- from energy and water utilities to Social Security -- to for profit multinational firms, crushing unions and other dissenters along the way.

    Insurance Exchanges Tilted Toward Health Insurers, Not Consumers

    The insurance industry made it abundantly clear this week that it is in the driver's seat -- in both Washington and state capitols -- of one of the most important vehicles created by Congress to reform the U.S. health care system.

    The Affordable Care Act requires the states to create new marketplaces -- "exchanges" -- where individuals and small businesses can shop for health insurance. In the 15 months since the law took effect, insurers have lobbied the Obama administration relentlessly to give states the broadest possible latitude in setting up their exchanges. And those insurance companies have been equally relentless at the state level in making sure governors and legislators follow their orders in determining how the exchanges will be operated.

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