We know that
health, education and poverty are linked. This is why, at one time,
the U.S had a Secretary of Health, Education and Welfare. Restoring
that cabinet post might go a long way toward inspiring discussion
about how to approach all three simultaneously. By viewing them as
separate problems, we “see” only one part of the
elephant. With that in mind, I have decided that, from time to time,
HealthBeat should look at ideas for educational reform.

The facts about
the connection between education and health are grim. A year ago
the Congressional Budget Office (CBO) issued a report
titled “Growing Disparities in Life Expectancy” which
revealed that “the
gap in life expectancy at age 25 between individuals with a high
school education or less and individuals with any college education
increased by about 30 percent” from 1990 to 2000. The
gap widened because of increases in life expectancy for the better
educated group,” the report notes. “Life expectancy
for those with less education did not increase over that period.”

People with less
education also are m ore likely to suffer from the disease many of us
dread most, the scourge we call
“Alzheimer’s.”
A 2008 study published in the medical journal Neurology  reveals those
with at least 15 year of education have a “cognitive reserve”
of extra neural connections, which allows their brain to handle more
plaques and tangles without showing Alzheimer symptoms. Conversely,
according to a 2007 study from Finland,
“people who don't finish high school are at a higher risk of
developing dementia and Alzheimer's disease compared to people with
more education regardless of lifestyle choices and [other]
characteristics.”

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Some
of President Obama’s critics have expressed disappointment with
his plans for healthcare reform. Why is the president raising taxes
to sink more money into an already bloated healthcare system? Why
isn’t he doing more to cut wasteful healthcare spending?

Earlier
this week, New Yorker writer and surgeon Dr. Atul Gawande
testified before the House Committee on Energy and Commerce
Subcommittee on Health. 

As
usual, he was eloquent, and, as it happens, much of what he said
speaks directly to the critics’ objections. But
first, consider what the skeptics have to say about the budget. Not
long ago The HealthCareBlog’s Matthew Holt declared
“There is NO
reason to put more money into the health care system.

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Over at  Centered Politics.com  Jim Jaffe once again has written a provocative piece about health care reform.  I don’t agree with him on every point. But I am persuaded by  his opening premise: the main lesson we need to learn from the 90s involves managed care, not the Clinton effort, which “was a one-off effort with unique problems.”.

The failure of the Clinton plan is all tangled up with the unique personalities and circumstances of the time. Dwelling on the Clintons’ experience only distracts us from the task at hand. The times and the cast of characters involved are very different—as different as Obama and Hillary, Peter Orszag and Ira Magaziner, or Mitch McConnell (Republican leader in the Senate today) and Bob Dole ( the Republican Majority leader in the early 1990s).

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Inevitably, the debate over healthcare reform will inspire some to try to broadcast misinformation, sowing seeds of doubt, false hope or fear in the public mind.  I will try my best to rebut some of the more flagrant attempts, on both sides of the issue. In the past, I have complained that progressive single-payer advocates sometimes exaggerate just how much could be saved if we eliminated private insurers’ administrative costs from the nation’s healthcare bill here (For an excellent, even-handed analysis of administrative costs for private sector insurers compared to public sector insurers, see this Urban Institute report)

But this post is not about single-payer. (If you comment, please stick to the subject at hand. Posting off-topic messages is considered “trolling,” and your comment will be removed.)

Instead, in this post, I want to talk about an example of fear-mongering by conservatives. Thanks to reader Brad F. for sending me this link to an AP video available on Yahoo headlined “GOP Challenges Obama’s Healthcare Plan.” 

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The Guardian asked me to watch and comment on President Obama’s HealthCare Summit.   The post, which I wrote yesterday, begins:

The White House Forum on Health Reform ended in a dialogue with President Obama that turned out to be the most revealing part of the afternoon. In that final hour, you began to hear the anger of the opposition – and you caught a glimpse of which principles the president himself considers most important. 

You will find the whole story here.

Regular readers may recall a blog where I questioned CNN chief medical correspondent Sanjay Gupta’s qualifications as a potential surgeon general.

I had planned to write a part two to that blog, but as Gupta’s name began to disappear from the press, I decided I would be beating a dead horse. I suspected that either the administration was having second thoughts about the nomination, or that Gupta himself was concerned that his ties to drug-makers might lead to embarrassing questions during confirmation hearings.

 Let me be clear: Dr. Gupta has not been charged with any wrong-doing.  But as Dr. James Floyd, researcher at consumer advocacy group Public Citizen, told ABC News yesterday: “Several of Gupta's broadcast reports undermine his credibility," whether reporting on autism or screening tests and prevention. 

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From Media Matters

“During the March 3 edition of Fox News' Special Report, correspondent Molly Henneberg reported on the opposition President Obama's health-care reform plan faces from the nonprofit organization Conservatives for Patients' Rights and stated: "Democrats control the White House and Congress, and they want Government-run health-care programs. Republicans may need groups like Conservatives for Patients' Rights — and their ads — to encourage public support for free-market solutions." In fact, the Democrats who "control the White House" have not proposed "government-run health-care programs." Indeed, according to the White House health-care Web page: "On health care reform, the American people are too often offered two extremes — government-run health care with higher taxes or letting the insurance companies operate without rules. President Obama and Vice President Biden believe both of these extremes are wrong

“Host Bret Baier introduced Henneberg's report by stating that Conservatives for Patients' Rights is launching "a multimillion-dollar advertising offensive." The report included a video clip of the group's chairman, Richard Scott, saying, "What ultimately happens is, the government always runs out of money, because they offer too much, and they offer — and so they always run out of money, so then they end up having to ration." Henneberg reported that Scott ‘started the Solantic urgent care centers in Florida,’” but  failed to mention how he created an empire of Medical fraud. (See my post below)

The conservatives have every right to organize opposition to health care reform. But tapping someone like Scott as their leader—without disclosing his background—means that they are reverting to old bad habits: Lying to the American People.

Perhaps Fox News will say “we didn’t know.”

 They don’t know how to Google?

Reader Jim Jaffe has written an excellent “prequel” to healthcare reform here.

He explains how we got where we are, and how and why the huge problem of over treatment was ignored for so long. 

Readers who are relatively new to HealthBeat may find this background particularly helpful, especially if you are not sure what I or other readers are talking about when we talk about over treatment as the big problem, or refer to “the Dartmouth Research,” or the fact that “higher quality and lower spending go hand in hand.” (For example, as Jim points out, the Mayo Clinic offers higher quality care than many other hospitals, at a lower price. Patients undergo fewer tests and treatments, see fewer specialists and
both outcomes and patient satisfaction are higher. )

Anyone who reads HealthBeat will, I think, find something valuable in Jim’s post.

Today, Politico reported on  a conservative initiative to block healthcare reform: “Firing some of the first shots in the coming showdown over health care, a conservative group led by the former owner of the Hospital Corporation of America is beginning a multimillion-dollar campaign Tuesday in opposition to government-run coverage.

“Conservatives for Patients Rights is going on TV, radio and the Web in the same week President Barack Obama hosts a health care summit at the White House. The group’s leader, Richard Scott, is hoping a pro-free-market message will rally the right to join the fray on what may be the most hard-fought policy battle in the first year of the new administration.

“’If we have more government involvement we’re going to have dramatically worse health care,’” said Scott, the wealthy health care executive who is overseeing the effort and seeding it with $5 million of his own cash.

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Over at Managed Care Matters,  Joe Paduda posted this letter from a “very good friend.” Does every patient in London get such good care? Probably not. But I have heard    similar stores—and the UK does not have the best care abroad. (The NHS is still under-funded, though each year they’re putting more money into it.) France, Germany, Sweden, Denmark any Switzerland all boast better care.

Finally, see the American doctor’s reaction at the end. I wonder if he has ever been in a hospital in London?

Five hours into an 11-hour flight to London last month I had a heart-related medical "incident" that caused me to faint, hitting my head on a trolley on the way down giving myself a concussion in addition to whatever else was ailing me. Although I (stupidly) refused the wheelchair and ambulance the airline had waiting for me at Heathrow, upon arrival at my hotel I was sent to the emergency room at St. Mary's Hospital in London where I spent the next 24 hours.

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