Your assignment.
Today is a writing/reporting day for me, meaning I’ll be clattering keys and making calls, but not in the service of you, dear blog readers. But fear not — I have something else for you to take a look at.
It’s my friend Ron French’s long-awaited (by some of us, anyway) Detroit News project on how health care costs are strangling General Motors. But wait, wait, there’s a bigger picture here, and this is it:
Because of its aging work force and army of retirees, GM has reached a health care crisis before the rest of the country. But GM’s battle with the health care beast may well be a preview of what America will be facing in coming years.
GM has staked its future on an unlikely crusade against the most expensive and sloppy medical system in the industrialized world.
The fact that in 12 years those efforts have scarcely helped prompts a frightening question:
If health care costs are driving one of the most powerful companies in the world deep into financial difficulty, how bad will the health care crisis be for the rest of us?
Every American who pays attention knows that one reason the auto companies want to meet with President Bush is to sell him on a vision of nationalized health care. Here’s a figure, for example, that people in Detroit know by heart:
The price tag of every vehicle GM builds in the United States includes about $1,525 just for the medical care of the nearly 1.1 million Americans the automaker insures. Toyota’s health care tab for each vehicle it builds in Japan is $97; it’s $400 to $425 in the United States.
(Before you wonder why Toyota can do it for $425 vs. $1,525 for GM, I can tell you it’s because Toyota has only been building cars in the U.S. for a short time, relative to GM, and doesn’t yet have the army of retirees and aging workforce that GM does.)
Some of you know about my steady-gig editing job, which I do as well as freelance writing. At night, I farm news for a single corporate client whose business is health care. In addition, I’ve spent a lot of August and September writing stories about health care, some of which haven’t run yet. Both jobs leave me believing we have entered the age of miracles, real miracles. One of the people I interviewed, for a story in October’s Hour Detroit (on newsstands now — buy two, tell your friends), had minimally invasive cardiac bypass surgery, using a robotic surgical tool; his doctor sat in another room staring into a monitor, operating tiny instruments introduced not through a gaping wound in his chest, but through five holes, each the diameter of a pencil. Another doc, an oncologist, talked about the amazing advances in biotech-engineered chemotherapy drugs, resulting in therapy that’s less debilitating and more effective. Some of his patients used to choose death over chemo, and now some don’t even lose their hair.
“And a course of chemo drugs used to cost $500,” he said. “Now it’s more like $50,000.”
I’m so stupid (how stupid am I?), I’m so stupid I thought health care would be the No. 1 issue the last presidential election, after the war. Instead, it was whether John Kerry spent Christmas in Cambodia in 1969.
Well, don’t want to get off on a rant here. Ron’s a great writer, and it’s a zippy read. There are several sidebars, all of which can be accessed from the the main DetNews page.
(Order your Amazon through me and I earn 4 percent. Click the “powered by Amazon” logo.)
Pam said on September 26th, 2006 at 10:06 am
Bill Clinton tried to address the health care problem in his first 100 days in office. Like a great CEO, he has the ability to see around corners. But instead, we had to debate why he chose Hillary Clinton to lead the effort. Couldn’t she just get a pearl choker and decorate the White House? That was a real compelling look at how certain interest groups can spin an issue so badly that we never even get to talk about it. Now it’s huge and we’re behind and people have ill informed and misconceived notions that even puts the discussion in the negative start position! I want facts and I want to hear the health care industry’s most creative people profer some ideas on how to get this problem under control. Before we all go broke!
Randy said on September 26th, 2006 at 10:36 am
Here in the Great White North, a friend-of-a-friend is on a wait list for a lung transplant. When he told his employers that he may be needing an extended leave, they offered to pay all his expenses for a consult and transplant in the US. (He’s their accountant, presumably aware of where all the bodies are located, ergo the VIP treatment).
Anyway, he’ll be able to get a transplant within the next twelve months in the US, because the cash is there to pay the bills. Here, he’s looking at three years, since it’s first-sick, first-served (not exactly, but close).
Sincerely, I’m not sure which system is better. If I was rich I guess I’d know my answer.
nancy said on September 26th, 2006 at 10:59 am
I can maybe answer that, Randy, since another story I did this month was on a double-lung transplant.
The NYT had a story Sunday about lung transplants in the U.S.; the eligibility rules were recently changed, and wait lists are now far shorter:
Starting in May 2005, new rules nationwide put patients who needed transplants most at the top of the list — people who would soon die without a transplant, but who had a good chance of surviving after one.
Previously, lungs went to whoever had been waiting longest, even if another patient needed them more. The waiting time was often two years or more, so there was little hope for people with lung diseases that came on suddenly or progressed rapidly.
Another major change is that more lungs from cadavers have become available, for two reasons: more people are becoming organ donors, and doctors have figured out ways to salvage lungs that previously would have been considered unusable. The new methods use drugs, respirator settings and other techniques to prevent damage to the lungs and keep their tiny air sacs open in brain-dead patients.
That’s just a snippet; read the whole story. The 20-year-old kid I wrote about had cystic fibrosis and was down to 10 percent of his lung capacity, sitting around on a vent and waiting to die. He’s now back playing tennis and has a normal life expectancy.
If Canada changes its policy to be more like the U.S.’s, he could maybe get it done there.
Marcia said on September 26th, 2006 at 11:40 am
Wow. That’s fascinating. I’ve been pondering the whole health-care mess myself for a while, and I don’t see any great answers.
My dad retired from Ford, and now, years later, they are making all kinds of changes to his health care plan, something he couldn’t have foreseen when planning for retirement.
Joe Hallett had an interesting column yesterday about how the “baby boomers have lived in an era of continual prosperity and relative peace” and how that is gone and not coming back.
Danny said on September 26th, 2006 at 11:53 am
I’ve kinda given up on the idea of depending on corporations and government for anything.
A few years ago I saw a bumpersticker that gave me pause for two reasons: at first I didn’t get it, and then, I did. The slogan: “Resist Corporate Personhood.”
That does not roll off of the tongue so micely, but it does nicely reflect some realities we see. Corporations screw workers quite often.
My father worked for Bethlehem Steel at the Sparrows Point plant in Baltimore for almost his entire adult life. As did many of our relatives, friends, and neighbors. If you know the saga of Bethlehem Steel, then you know that any of them who are still alive are totally screwed health care-wise and pension-wise.
So we are not counting on pension, social security, nor even partially-employer-paid health care. Instead, we’re trying to live well below our means and saving and investing as best we can. Most of my neighbors are driving Beemers and Mercedes. I drive an 11 year old 4 Runner and my wife a zippy, dependable Sentra that we bought new 2 years ago.
And I consider the bike, pool and gym a very, very big part of my long term health care plan.
Danny said on September 26th, 2006 at 11:57 am
Oh, and I really, really must recommend Quicken to any of you who do not already use it. Once you categorize your expenses, you will see exactly where your money is going and be able to make informed decisions about how to adjust. We did this about a decade ago and were very surprised. Hint: we eat at home a lot now. And we like it better too.
mary said on September 26th, 2006 at 12:16 pm
There are an awful lot of people who don’t have the choice between a beemer and a sentra.
nancy said on September 26th, 2006 at 12:28 pm
Danny, your lifestyle and choices are commendable, and I don’t mean to criticize them. But relying on frugal living to take care of your health-care needs is as much wishful thinking as anything.
Yes, you’re likely not to get Type II diabetes and its attendant miseries, and good on you for that. But what if you or your wife gets cancer? It strikes down the health-conscious and flabby alike — will you be able to pay $50K for a course of chemo? What if you need two? What if you’re offered a third, “just to make sure we got it all” — do you spend for that one, or roll the dice?
I see Marcia dropped in, too. She’s a neonatal nurse in Columbus, takes care of extreme preemies. Let me see the hands of all the parents willing to say, “Go ahead and let my baby die.” (Read this before you answer.) Life is a terminal disease, true, but what is a year of it worth? Does anyone not believe, if we go to a pay-as-you-can system of health care, that we’ll see Saudi princes and Donald Trump living to 120 and everyone else praying for death as one’s personal finances run out?
Marcia points out the obvious: Technology has far outpaced our ability to keep up in an ethical fashion. And now it has outpaced our ability to pay for it. And how are we coping? By putting our hands over our ears and saying, “La la la la Hillarycare la la la la la.” It makes no sense.
Danny said on September 26th, 2006 at 1:17 pm
Nance, I’m in total agreement. Regardless of lifestyle, there are no guarantees for anyone. It’s just that I have given up on things that I see as well outside of my sphere of influence: namely, government and corporate policies/decisions. If there is one thing that situations like Bethlehem Steel and Katrina should have taught us, it is that we are on our own.
Unfortunately, I don’t see that as changing in the foreseeable future. Regardless of who is in charge.
mary said on September 26th, 2006 at 1:30 pm
Maybe we should also look at the situation of the uninsured, and the huge burden that is putting on the health care system. It’s as instructive as anything that happened with Bethlehem steel.
One in six of us is uninsured, including millions of children. Do I file that piece of information away in the “out of my sphere of influence” bin?
mary said on September 26th, 2006 at 1:45 pm
Thanks for linking to Marcia’s blog. What the nurses do in NICU is so far beyond anything I could ever achieve. I go to the NICU unit about once a week, sometimes with a new nurse we’re hiring, sometimes just to see what’s going on there. I could never be a nurse. They deserve so much respect.
Danny said on September 26th, 2006 at 1:50 pm
Well, you and I have a vote, but as far as I can see, that is about it with regard to our influence on government policies on health care. That is what I am trying to say.
As far as my personal sphere of influence, that is different. I am not preaching rugged self-reliance at all, or self-reliance for the sake of self alone We really try to be there for those in need. I can’t give them insurance, but I can buy people groceries, I can let them live with us in our small condo and I can give to charities that try to make up for the gaps in health care.
mary said on September 26th, 2006 at 2:31 pm
You and I have a vote and you and I can let our representatives know that the health care crisis is important to us. It’s going to have a much bigger effect on our lives than gay marriage and flag burning and mentioning a deity in the pledge of allegiance. It’s going to cost every one of us a lot of money, much more than if we had universal coverage.
Marcia said on September 26th, 2006 at 2:42 pm
Oh, my gawd, Nancy linked to me!! Cool!
Um, I have a little more on the subject matter at hand:
Marcia said on September 26th, 2006 at 2:44 pm
Of course, the invisible link doesn’t work very well.
It’s just about what’s necessary and what’s not when it comes to health care, specifically in the NICU.
brian stouder said on September 26th, 2006 at 3:38 pm
An excellent article. I was particularly struck by these bits
In 1962, half the cars sold in America were made by General Motors. Flush with money, GM offered generous health coverage and deferred benefits (retiree health benefits and pensions) instead of higher wages. That choice made sense because health care was inexpensive, and the future medical bills of retirees didn’t have to be charged against revenue until they occurred. In essence, GM was buying health care on credit.
I didn’t realize that GM had always gone for ‘self-insurance’. Apparently they didn’t reserve enough cash over the years, for the liabilities that they assumed (which presumeably is what the women and men in the insurance company skyscrapers do every day). Afterall, insurance companies (that is to say, companies that exist to sell insurance, as opposed to Impalas) don’t seem to be hurting, by and large –
And what is GM getting for all that money? Despite having the Cadillac of health coverage plans, GM employees don’t live any longer than other U.S. blue-collar workers, according to GM data.
I find that somewhat breath-taking.
Dorothy said on September 26th, 2006 at 3:40 pm
Ah medical insurance… We spent lots of time in two different hospitals this weekend after Mike fell off a ladder Friday night. At the second hospital, a nurse in the ER asked in this hopeful voice “Do y’all have insurance?” When we answered affirmatively she let out a huge breath of relief. It certainly makes things easier when you have it, that’s for sure.
mary said on September 26th, 2006 at 4:08 pm
Emergency rooms can’t turn you away if you have no insurance, so I’m sure your insurance card was a welcome sight. Sorry to hear about your husband’s ankle and foot. Take good care of it, as ankles can be really hard to heal. Lots of little bones and ligaments and all that.
Dorothy said on September 26th, 2006 at 4:18 pm
That’s what they kept telling us, Mary, and I am dreading what lies ahead. But we’re a team and I’ll work hard to get him through this. I’m just glad we had our week at the beach the week before this happened.
nancy said on September 26th, 2006 at 4:26 pm
Oh, and Dorothy — sorry to be late to the party, but let me add my get-well-soon wishes to the pile. Make sure he does all his p-therapy. And thanks for reminding me why I pay strangers to clean my gutters.
Dorothy said on September 26th, 2006 at 5:03 pm
Yeah a coworker said the same thing about therapy. She broke her ankle badly in Vail 2.5 years ago and she knows all about the importance of going to therapy. We’re ready to write a check to the first contractor who’s willing to take over the job mid-wall!! Hell, he/she won’t need any supplies. We have paint, rollers, trimmers, brushes, tarps, and LADDERS. Three of ‘em.
Ricardo said on September 26th, 2006 at 6:39 pm
I don’t think that GM ought to be in the business of supplying worker’s health care. They could partner with Canada as should the states of Michigan and California, etc or partner with some successful European source, the US government isn’t interested.
GM didn’t used to be in the health care business. During the wage controlled 1940s health care was offered as a way of getting around the controls for recruitment advantages. Little did they know….
National health care would drive down total costs and one of the advantages would be to improve competitiveness of our industries, but with politicians in the pocket of health care for profit lobbyists, that’s not going to happen soon.
John said on September 27th, 2006 at 7:41 am
I finished my phyisical therapy in late June for my shoulder (surgery in May). God bless both of my therapists! Both were hard as nails but encouraging and very well educated. My range of motion is back to normal with no pain.
Jim said on September 27th, 2006 at 8:49 am
I admit to not knowing much about this issue. But if health care is too expensive for private industry, why would it not be too expensive for the federal government? The money still has to come from somewhere. Being a Soldier, I have wonderful health care for myself and my family — all government-provided, of course. And I think the system works well. But I also know that it is tremedously expensive and eats up an increasing amount of the defense budget. My impression (and those of you who know, please correct me) is that health-care costs are so expensive for those who do pay to cover the expenses of those who do not pay. The problem is finding a way to provide health care (not necessarily insurance) to those who cannot afford it without diluting the quality of health care for those who can.
TS said on September 28th, 2006 at 10:10 am
Nationalizing health care as a strategy for cutting costs is an illusion. Those oldsters complaining about $5 co-pays need to get over themselves. As Sally Pipes wrote, “Yet risk pooling won’t reduce overall spending or even individual affordability. A dinner party analogy demonstrates why. If a person can’t afford a steak, letting everyone order a steak, pooling the bill, and distributing it back to individuals doesn’t make the steak more affordable. As a society, there is no other table to which to send the bill.”
Full thing here: http://books.nationalreview.com/review/?q=ODczN2Q5MjY4ZTMzMTFjM2M5ZjZiNDI0OTEzZGVjYTc=