Rick Santorum, It Takes a Family 9

In my latest reading of It Takes a Family: Conservatism and the Common Good, Rick Santorum talked about abortion.  Sub-topics included: How he arrived at his pro-life stance; how he did not focus on abortion in his congressional and Senatorial races (in areas that had a lot of Democrats) but felt compelled to take a public stand in the partial-birth abortion debate; how his wife had a baby with severe defects (the sorts of babies who are often casualties of partial-birth abortion) and loved that baby during the baby’s brief life; and how Santorum gave a hundred minute speech against partial-birth abortion in a last-ditched attempt to gather votes to override President Bill Clinton’s veto, and, while he failed to get the votes, he did dissuade a lady watching him on C-Span from having an abortion.  There was more to my reading, but those were some of my favorite passages.

Santorum makes an excellent point on pages 262-263, but my question is whether his statement there is at odds with other things he has said.  Santorum states: “I know that for so many women this is the most painful decision in their lives: but the family, the churches, community organizations, and even the government have to be there to help.  Not just during the pregnancy and after the baby is born, but before.  I have introduced a bill to provide government grants for organizations that provide everything from prenatal care to diapers and baby clothes.  If abortion proponents are interested in ‘choice,’ they should join us in helping poor women afford the choice to have a baby.”

But how does this jive with Santorum’s criticism of the welfare system (which serves many low-income single mothers), and his statement during his Presidential campaign that health insurance should not be required to cover prenatal tests, which he thinks will encourage abortions because parents could abort their kid when they learn that he has defects?  Prenatal tests could do that, but they could also be an essential part of prenatal care.

Moreover, Santorum talks about how there are babies with birth defects who survive through medical care, against those who argue that partial-birth abortion may be necessary on account of such babies.  Santorum makes a valuable point, but that kind of medical care probably costs a lot, especially in America’s health care system.  Health care reform should be part of a pro-life policy.

One area in which I was disappointed in Santorum’s discussion about abortion is that he did not talk much about cases in which having a child can take a serious toll on the physical health of the mother.  He mentions that particular argument, so he is aware of it, but (at least in my latest reading) he does not engage it.  I think that this aspect of the debate is important, for one reason that Bill Clinton had issues with banning partial-birth abortion was that he did not feel that the bill in question contained a sufficient exception for the health of the mother.  I recall reading a reference Clinton made to mothers becoming crippled on account of childbirth.

Newt Gingrich on Health Care in Real Change

I read the material about health care in Newt Gingrich’s 2008 book, Real Change.  I have four items.

1.  One topic that Newt addresses in Real Change that I did not see in Saving Lives & Saving Money is doctors and dentists who defraud Medicare and Medicaid—-by overbilling the government or by requesting reimbursement for services that they did not perform.  Newt believes that this problem costs the health care system money, and he attributes it (at least in part) to bureaucratic incompetence.  After all, he says, while federal bureaucrats go home at 5, defrauders work long hours to figure out ways to cheat the system!

2. On page 227, Newt states that “Allowing individuals to pass their health costs onto others reinforces the attitude that their health is not their problem and adds to the irresponsible, unhealthy behaviors that bankrupt the current system.”

I don’t think this is entirely fair.  For one, a lot of individuals do not solely pass their health costs onto others in America’s health care system.  Even many who have health insurance have high premiums and copays, plus their insurance company may choose not to pay for certain treatments.  Second, it’s the current health care system that discourages preventative care, by making people reluctant and afraid to see a doctor on account of high medical costs.

To his credit, Newt is a strong advocate for preventative care.  He wants for the government to lead by example by incentivizing that, and he presumes that private health insurance companies would then follow its lead.  I hope so!  You’d think that private health insurance companies would support preventative care, since that costs them less than catastrophic care, leaving a larger profit for them.  At least that’s my opinion about how it would work, and I could be mistaken.

3. On page 235, Newt favorably quotes Franklin Roosevelt, who stated: “The success or failure of any government in the final analysis must be measured by the well-being of its citizens.  Nothing can be more important to a state than its public health; the state’s paramount concern should be the health of its people.”

I think that this sentiment is biblical (if that matters to you), for Ezekiel 34:2, 4 criticizes the rulers for not curing the ill or binding the broken.  Moreover, the U.S. Constitution talks about promoting the general welfare.  The government is supposed to be concerned about the health and well-being of the country’s citizens.

Unfortunately, when I hear many conservatives and libertarians talk, the vibe that I get is that they don’t think the government should be concerned about health care.  For them, the government should keep out of it, and people should be responsible for their own health—-for good or for ill.  I respect conservatives and libertarians who talk about ways to bring down the cost of health care, but I do not care for the callous approach that some of them appear to convey when discussing what the government’s role should be (or should not be).

4.  Did Newt Gingrich support a health insurance mandate, which now is a significant part of President Obama’s health care plan (though I am writing this post on April 7, before the Supreme Court has decided on whether or not the mandate will remain a part of the health care law)?  I did not see that in Saving Lives & Saving Money (which was published in 2003), for, while Newt highlighted the importance of universal coverage, he focused on how to make it cheaper for people to purchase health insurance, without mentioning a mandate.  In Real Change, however, he appears to support a mandate.  On page 276, Newt states: “…we should insist that everyone above a certain level buy coverage (or, if they are opposed to insurance, post a bond).”

Newt Gingrich’s Saving Lives & Saving Money 11

In my latest reading of Saving Lives & Saving Money: Transforming Health and Healthcare, Newt Gingrich praises a Computerized Patient Record System that the Veterans Administration plans to use:

“The provider ‘view,’ Computerized Patient Record System, organizes and presents all relevant patient data in a way that directly supports clinical decision making.  The comprehensive cover sheet displays timely, patient-centric information, including active problems, allergies, current medications, recent laboratory results, vital signs, hospitalization, and outpatient clinic history.  This information is displayed immediately when a patient is selected and provides an accurate overview of the patient’s current status before any clinical interventions are ordered.”

This makes sense.  It’s better than what happens a lot of times now, when doctors ask patients the same questions over and over (i.e., Have you ever been hospitalized?  Do you use medications?, etc.), or the right hand may not know what the left hand is doing.

Newt Gingrich’s Saving Lives & Saving Money 8

In my latest reading of Saving Lives & Saving Money: Transforming Health and Healthcare, Newt talks about the importance of increased government spending on scientific research.  In some cases, this would be to combat diseases, such as Diabetes and Alzheimer’s.  In some cases, it would be to promote national pride, as the space program does.  While Newt acknowledges that he wants for the country to spend more money on scientific research, he believes that doing so will save the country money in the long run, since Diabetes takes a toll on America’s health care system.  I’m cool with this argument, but I wonder how America could do this and cut taxes at the same time, which I say in light of Newt’s tax cut proposals.

I liked what Newt said on page 182 about education:

“…we teach these subjects as facts to be memorized rather than a great adventure of discovery to be pursued.  Teaching, memorizing, and testing are all familiar words.  But we must return the words wonder, adventure, and discovery to our schools.  We should not center on education, but on learning.  We should go beyond force-feeding numbers and theories to a level of true discovery where a child wonders what the answers are and goes in search of them for the pure excitement of it.”

I was one time working with a program that tutored at-risk youth, and I remarked that I could understand why the youths were so bored with what they were learning in school, for I was bored with that stuff and was happy to be in college where I could pursue my interests and take the courses that I wanted.  My supervisor responded that my opportunities to do so in college were my reward for doing well in the boring subjects in junior high and high school.  I think that it’s important for students to learn subjects that may not necessarily interest them.  At the same time, I believe that schools should encourage students to pursue their interests, and that opportunities to do so should not be limited to the gifted and talented or to those who go on to college.

Newt Gingrich’s Saving Lives & Saving Money 7

For my write-up today on Newt Gingrich’s Saving Lives & Saving Money: Transforming Health and Healthcare, I want to highlight what Newt says on pages 145-146:

“The current system dictates a focus on reactive acute care and does not incentivize prevention.  Coverage for prescription medications is a paramount example…Medicare will cover the visit to the doctor to discuss the numbness in the foot, but it will not pay for the insulin to relieve, and stop, the problem.  Medicare will pay for visits to the emergency room when a beneficiary has a heart attack, but it fails to pay for the cholesterol medication that may have prevented the incident all together.  Medicare’s end-stage renal-disease program (offers kidney dialysis when the kidneys no longer function) is one of the highest cost programs in Medicare, yet it will not pay for the insulin that could prevent many of those individuals from needing it in the first place.”

Newt wrote this before the Medicare prescription drug entitlement was passed into law.  And what Newt said makes sense, for you would expect for prevention to save money by reducing the number of people who end up in emergency rooms.  But did the prescription drug benefit save Medicare money?  As far I as know, Medicare spending has continued to increase since that benefit was passed.  Why?  Is it because the donut hole requires some people to still pay for their prescription drugs, thereby hindering them from a health-plan of prevention?  Is Medicare Advantage part of the problem, as I have read that it entails the government giving money to insurance companies, plus there are questions about the quality of Medicare Advantage plans?  Is the sheer cost of prescription drugs part of the problem?

Newt Gingrich’s Saving Lives & Saving Money 6

For my write-up today on Saving Lives & Saving Money: Transforming Health and Healthcare, I’ll highlight what Newt Gingrich says on pages 110-111:

“In a world where we have the ability to do our own trading on the stock market, it should be unacceptable that we are still at the mercy of an insurance company to understand care options, provider choices, and costs.  The role of a patient has evolved into a dependency relationship in the healthcare delivery system rather than the driver of the system.  Access to information and knowledge about healthcare will empower individuals, as consumers, to make the best healthcare choices in deciding which procedures, treatments, and preventive care will meet their mental, emotional, and physical needs.  We want to know that the physician performing our hip and knee replacement has done the procedure enough times to be proficient at it.  We want to know that if we have type 2 diabetes, our doctor has a high percentage of success in treating patients with that condition.”

But what if you do an online search and find a doctor you like, and the insurance company doesn’t cover a visit to that particular doctor?  Knowledge is not necessarily power, especially in a system where one is dependent on the insurance company.  I wonder how Canada would handle this: Can Canadians visit any doctor in the country, and the government pays for it?

Newt Gingrich’s Saving Lives & Saving Money 5

In my last reading of Saving Lives & Saving Money: Transforming Health and Healthcare, Newt Gingrich talks about offering incentives for healthy living.  I enjoyed his anecdote on page 101:

“The amount of hours we worked and the time my staff and I spent in the Speaker’s office made it very easy to make poor dietary choices and not exercise.  Leftover cookies and appetizers from meetings and receptions, fast food, and tuna melts from the grill led to almost everyone in the office gaining weight over the first year.  Someone in the office started a weight contest, who could lose 8% of their body weight in eight weeks.  Everyone who wanted to participate put in $20 and weighed in with the weight keeper.  It became a team approach to healthy behavior.  After eight weeks, two of the staff had achieved their goal, winning about $150 each, and quite a few others were close behind.  This is not a revolutionary idea but the kind of healthy, team-building activity that could be replicated in any workplace.  It just takes leadership.”

I appreciate this anecdote because it gives me a glimpse into what life in Washington is like and also shows that Newt and his staff were pretty cool—-in that they had the camaraderie to hold a weight-loss contest.

In terms of the incentives that society can offer for healthy living, Newt on pages 101-102 suggests “lower co-pays for patients who are compliant with their health-management requirements.”  I wonder how that compliance would be measured.  Would it be through such things as weight-loss and low cholesterol?

Newt Gingrich’s Saving Lives & Saving Money 4

I have two items for my write-up today on Newt Gingrich’s Saving Lives & Saving Money: Transforming Health and Healthcare.

1.  On pages 73-74, Newt talks about childhood nutrition.  He laments that “School lunches…contribute to instilling unhealthy eating habits in children” because they “are high in carbohydrates and fail to offer a variety of healthy alternatives such as soymilk”, when “Foods containing soy protein are effective in reducing cholesterol, treating kidney disease, and may cause calcium to be better utilized, helping to ward off osteoporosis.”  Newt states that the dairy industry is being put ahead of children’s nutritional needs.  Newt then discusses a school district in California that has banned sodas on campuses, replacing them with milk, “beverages with at least 50% fruit juice, and sports drinks with less than 42 grams of sugar per 20-ounce serving”.  Newt says that childhood obesity is a growing problem.

Newt goes on to say that he’s not in favor of banning soft drinks and whole milk, but that people should learn about balance.  But Newt may support the school’s ban on soft drinks, for he says that “The soft drink companies should be challenged to expect to produce healthy alternatives or to expect to have reduced access to young people as a market.”

What Newt said in this 2003 book intrigued me, in light of conservative snark about Michelle Obama’s anti-obesity campaign (see here).  I wonder what the difference is between Newt’s approach to this issue and that of Michelle Obama.

In any case, as much as I like soda, I think that schools should promote healthier dietary habits.  Many conservatives decry Michelle Obama’s anti-obesity program as characteristic of a big government nanny state, and some of them defiantly affirm that they have a right to eat whatever they want, even if it’s unhealthy.  But eating in an unhealthy manner doesn’t just affect the person eating in an unhealthy manner.  It produces health problems that impact everyone else—-in terms of higher health care costs and insurance premiums. 

I wouldn’t go so far as to say that the government should ban junk food.  I seriously doubt that Michelle Obama goes that far, either.  But schools and school lunches should be stocked with healthy food and drinks.  Michelle Obama does well to work with restaurants to encourage them to have healthy items on menus.  A health care program that encourages preventative care—-which entails doctors coaching patients to eat right—-can benefit individuals and society as a whole.

2.  Newt once again expresses disapproval of third-party payers for health care.  Newt supports health savings accounts—-tax-free accounts of employees to which employers will contribute.  But Newt’s proposals do not get rid of insurance altogether.  Newt believes that health-savings accounts will reduce premiums because people would have money in their account for medical needs, and thus could have a higher deductible in their health insurance.  Newt also wants to move America away from employer-based health insurance, yet he recognizes that it’s more expensive for individuals to purchase health insurance.  As a solution, he proposes a tax credit for the individual purchase of health insurance, and also that groups (i.e., of small businesses, organizations, etc.) be able to purchase health insurance.

I think that these ideas are a step in the right direction, but I doubt that they’re adequate for everybody.  Would a tax credit help individuals who don’t make enough to pay much in taxes to begin with?  Would health-savings accounts provide enough money for costly operations?  Moreover, while Newt’s proposal that small businesses come together to purchase health insurance may have merit, I question whether Republicans have the will to push for this.  I remember George W. Bush supporting this idea when he debated John Kerry.  Then Bush won, and I didn’t hear about the idea again.  (But maybe Bush did mention it, since he supported some proposal regarding health insurance, which was rejected by the Democrats.)

“Government to shut down Texas women’s health program”

Reuters recently had a story entitled Government to shut down Texas women’s health program.  The opening paragraph states:

“The Obama Administration on Thursday said it would begin shutting down a program that provides health care for more than 100,000 low-income women in Texas because the state will not allow funding for clinics that provide abortion services.”

Essentially, the Obama Administration will not provide federal funding for this health program that serves low-income women, due to a Texas law prohibiting any of that money from going to clinics that perform abortions, even if the money is not paying for abortion itself (as that is against federal law).  Federal law requires that the women benefiting from the federally-funded program have freedom of choice in what clinics they will visit, and the Obama Administration believes that Texas is undermining that with its new law. Consequently, the Obama Administration is cutting off federal funding for the program, even though the “federal government pays about 90 percent of the [program's] cost”.

Texas Governor Rick Perry has committed himself to finding money so that the program can continue, saying: “It is the height of political posturing for the Obama Administration to put the interests of abortion providers and their affiliates, like Planned Parenthood, over the well-being of more than 100,000 low-income Texas women…I will not stand by and let this administration abandon these Texas women to advance its political agenda…Texas will fund these services with or without the federal government.”

I have problems with the Obama Administration’s decision, for I think that women’s access to health care should be paramount.  But isn’t Texas undermining that by restricting the clinics that women can visit?  Perhaps, but what good does it do for the Obama Administration to cut off funding altogether?  Who’s helped by that sort of policy?  But perhaps the Administration can’t do much else, since it has to follow the law.

Notwithstanding my reservations, I find the reaction of many conservatives to Obama’s policy to be ironic.  Many conservatives believe that the states rather than the federal government should handle health care, and a number of conservatives who are Christians maintain that charity is something that should be handled by the church, not the federal government.  So shouldn’t they be happy about the Obama Administration’s decision?  Instead, they claim that cutting off federal funding will destroy the program.  But, if they believe that federal funding is necessary to support the health of low-income women, doesn’t that undercut their entire argument that the federal government’s involvement in health care is neither necessary nor desirable, and that the state and the private sector are sufficient to handle the issue?   

I think that one thing that has been illustrated by this and other incidents is that government money entails government control.  Conservatives have long claimed this, and we are seeing it before our very eyes.  We see it in this case (in the policies of both President Obama and also the Texas legislature and Rick Perry, who themselves are attaching conditions to government money), and also when the government chooses not to give money to Catholic adoption agencies that discriminate against same-sex couples.  The problem is, can these programs exist without government funding?  I wish they could.  But my impression is that health care is too expensive for the private sector on its own to be able to support health care programs for the low-income.  Plus, many people (in my view) are too selfish to support these programs on a private basis, and I include a lot of churches in this.

FSE: The Biggest Loser

This is a free style entry. What is that? Well, whenever I go home to my dad’s in Indiana, I have to put up with a slow, dial-up Internet. Ordinarily, when I am in my Ohio apartment, I try to put a little research into my posts, and I can do so because I have high speed and can create all of these windows for articles and searches, even as I am writing. I can’t do that on my dad’s Internet. In fact, I’m having difficulty right now typing on it. So a free style entry is a post that is unrefined. It doesn’t have much research backing it up. It is basically my gut-level reaction to various issues. Anything I say in a free style entry should not be used against me, since the fact that it is a free style entry constitutes a disclaimer. I’ll indicate that a post is a free style entry with the initials “FSE.”

Okay, now to my post. Whenever I go home, I have an opportunity to watch shows that I normally do not watch. Yesterday evening, I saw a reality show called The Biggest Loser. In my own apartment, I don’t watch reality shows, since I think they’re a waste of time. But I was at my dad’s, and my sister was there, and she likes this show, and there was nothing else for me to do, so I watched it with her.

Essentially, the show is about obese people who are trying to lose weight through a rigorous exercise and diet program. Those who do not lose enough are voted off the program. I guess that what made yesterday unique was that the person voted off was actually a hard-working and well-liked person, so she was a threat to those who were not on her team. The show is hosted by Sami of Days of our Lives (another show I only watch with my sister, never on my own), and even she cried at the contestant’s departure.

One thing that struck me about the show was that all of the contestants were saying that they were “new people” after their weight loss. My reaction was, “No, you’re the same person, only you weigh a lot less.” But they’re measuring themselves by how they look. They think that if they look better, they are better. Society values physical appearance an awful lot. I know that I do that myself, but I really don’t think about how prevalent it is in society until I see a show like this. The reason may be that everyone looks good on the shows I watch, so The Biggest Loser reminds me that there are people who don’t look like celebrities, feel bad because of that, and work to gain acceptance through improving their appearance.

But my analysis is a little one-sided, for they are also improving on the inside through their participation in the program. They are learning self-discipline, self-confidence, and commitment. They are also becoming healthier, which makes them feel good. So there are qualities that they are developing, but the goal of the whole process is a good physical appearance, which is apparently an idol in today’s culture.

Personally, I wish that I could motivate myself to exercise and eat right. I walk uphill to school, and yet that has not helped me lose weight. I really don’t want to count calories before I eat something. I’m actually going to enjoy my Thanksgiving dinner tomorrow, and I don’t care how many calories I take in. I don’t plan to eat a piece of asparagus while others enjoy turkey, pumpkin pie, cranberry salad, and the other trimmings. So I admire those who are willing to put themselves through pain for any reason, even to look better. I just find that I prefer to enjoy things. Still, maybe I can exercise a little more.