Unwholesome Frame

To Err Is Human

The National Academy of Science’s Institute of Medicine report entitled “To Err Is Human,” which claimed that between 44,000 and 98,000 Americans die every year as a result of medical errors… outlined a series of recommendations…

[6][http://www.sciam.com/article.cfm?id=physician-heal-thyself]

Healthcare providers would be required to inform state governments of any medical errors leading to serious harm; currently only 20 states have such reporting requirements.

Nancy Dickey, a past president of the American Medical Association, which supports the panel’s recommendations, was concerned about mandatory reporting and public disclosure of serious medical errors.

Dr. Dickey said: “On the surface it appears to be a relatively straightforward step but actually it engenders all sorts of problems with confidentiality and liability.”

[7][http://www.bmj.com/cgi/content/full/319/7224/1519]

June 19, 2008

Wrong Leg Amputated? Massachusetts Won’t Pay, But You Will

In the interest of “protecting patient safety,” the Massachusetts Department of Health and Human Services has selected 28 “serious reportable events” that it will not pay for or allow hospitals to bill them for. These include surgery on the wrong body part or patient, performance of the wrong surgery, retention of a foreign object after surgery, and even death! Other nonpayable events include discharging an infant to the wrong person, patient suicide, disability stemming from medication errors, and more.

…

To sum up, those of us with private insurance could feasibly get the wrong leg cut off and still have to foot (har har) the bill, but the state insured can relax in the knowledge that nobody will get paid if their surgery is botched.

[8][Kerry Skemp in News – http://bostonist.com/2008/06/19/massachusetts-health-care-doesnt-pay.php]

Wholesome Frame

“Privateering” should not be the center of the health care issue

First, let us distinguish between health care and health insurance. Health insurance companies make their money by denying health care: either refusing to insure people with preconditions, turning down recommended procedures, or limiting the amount to be paid out for some condition…

This is the opposite of the way most markets work. In a typical market, companies that provide more of their product tend to make more money. In health insurance, the product is health care. But the more care an insurance company provides, the less profit it makes. In a normal market, greater competition helps consumers. But with health insurance, competition is competition for profits, not for delivering care. Greater competition for profits thus means competition to deliver less care, which harms consumers. Health insurance is thus an anti-market phenomenon.

Second, health insurance greatly adds to the cost of care. While Medicare has administrative costs of 3 percent, HMOs [Health Maintenance Organizations] have administrative costs of about 25 percent. Most of that money is spent on determining ways to deny care. On top of that, HMOs make a considerable profit, so that administrative costs plus profit amount to more than it would take to insure everyone under a Medicare-for-all or single-payer plan.

Third, health care falls under the moral mission of the government to protect its citizens from the ravages of disease, or injury, or the natural decay of the body as one ages. Sooner or later all our citizens will need health care.

Other forms of protection for the public do not require insurance. The police don’t ask whether you have insurance and are up on your premiums when a burglar breaks into your house, nor does the fire department when your house catches fire. Basic protection is, or should be, a function of government, and that includes health security.

But conservatives favor privateering—eliminating the capacity of government to provide health security through Medicare and then placing health care in the hands of insurance companies whose main mission is making money and who make their money by denying care.

Here government functioning is prevented … [by privateering enablers] from doing its job, and private companies make lots of profit as a result, often on government contracts. (Lakoff, 2008, p.????)

Unwholesome Frame

Five farmers were shot dead…

On 13th June 2005, 5 farmers were shot dead in Tonk during a protest demanding their share in the water from Bisalpur dam, which is diverting water from villages to the city of Jaipur under an [Asian Development Bank] [ADB] project for water sector “reforms” in the State of Rajasthan …

The real politics of water is … World Bank / ADB and other aid agencies creating water markets for global water [Multinational corporations] [MNCs] while robbing the Indian people both hydrologically and financially… [T]he World Bank started to push the Delhi government to privatize Delhi’s water supply… The contract between Delhi Jal Board … and the French company Ondeo Degrement (subsidiary of Suez Lyonnaise des Eaux Water Division—the water giant of the world), is supposed to provide safe drinking water for the city …

On December 1, 2004, water tariffs were increased in Delhi. While the government stated this was necessary for recovering costs of operation and maintenance, the tariff increase is more than ten times what is needed to run Delhi’s water supply…

The tariff increase is not a democratic decision, nor a need based decision. It has been imposed by the World Bank… The tariff increase hides significant increases…

Cremation grounds, temples, homes for the disabled, orphanages which paid Rs. 30 will now pay thousands of rupees….

The World Bank driven policies explicitly state that there needs to be a shift from the social perception to a commercial operation. This worldview conflict lies at the root of conflicts between water privatization and water democracy. Will water be viewed and treated as a commodity, or will it be viewed and treated as the very basis of life?…

The poor peasant, already struggling under the burden of debt, driven to suicide, will be wiped out if she/he is denied access to water and made to pay for a resources that is their common property… (Kanbur, 2007 | direct link)

Wholesome Frame

“Water is a public good…

Water is a commons, a public good. Privatization is the enclosure of the water commons. Water privatization aggravates the water crisis because it rewards the waste of the affluent, not the conservation of resource prudent communities. Sustainable and equitable use needs water democracy, not water privatization.”

“Water is a fundamental and inalienable human right and a common good that every person and institution of this plane should protect. This resource is, like air, a heritage of humanity and must be declared that way.

Water is not a merchandize and no person or institution should be allowed to get rich from the sale of it. It should not be privatized, marketed, exported or transferred to a few multinational companies, which today already control 90 percent of privatized utilities. For the GATT, NAFTA and FTAA, water is a commodity, an investment, a simple service for commercial use and profit.”

Leaving to one side the concern about monopoly market structure […] this perspective is fundamentally opposed to the buying and selling of water. This is difficult for economists with their “consequentialist gene” to comprehend. Why take such a position? Why not base the argument on the consequences of alternative arrangements—state, market, or in between?

The answer can perhaps be found if we pose the following question. On this argument, why not leave the market for child sex to a consequentialist decision? Or the market for human slaves? Reflection on this will reveal that there are some commodities, the trading of which cannot be countenanced no matter what the consequences. Indeed, the consequences may be harmful, but that is not the point. The argument stops well before we get to those. At the very least the argument is at a different level.

(Kanbur, 2007 | direct link)

• Retracing Our Response-Ability

  • Part 1 Our Common Dis-ease
    • Examining the Essentials
      • Water
    • Describing the Basics
      • Right and Wrong?
      • Health
•