Daschle Will Lead Health Care Overhaul – NYTimes.com
At the heart of the health care system, Mr. Daschle wants to establish a Federal Health Board, an independent entity like the Federal Reserve. The board would make coverage decisions for federal health programs. It would, he says, “reduce or deny payment for new drugs and procedures that aren’t as effective as current ones.”
The board could have a “spillover effect” in the private sector, he said. Private insurers already follow many of Medicare’s coverage decisions. Mr. Daschle said Congress could go further and link tax breaks for private insurance to compliance with the board’s recommendations — a step that would give the government far more influence than it now has.
That sounds like a great idea! Obviously, the board will have to be super-independent, with legislation to ensure they aren’t being moved by free gifts or implicit career offers from HMOs or drug companies. Still, it’s an enormous problem, and one source of our stratospheric healthcare costs, that there doesn’t seem to be any check on the cost or utility of new drugs or devices. A popular drug may have a generic equivalent that doctors or patients stubbornly aren’t using. A hospital may have purchased an MRI machine and wants to recoup the costs by using it to investigate headaches (a breach of the enormous trust patients place in their doctors). A big new drug may be just like an old one, different enough only as to warrant a new patent. And, of course, there’s the rush for drug companies to create “blockbuster drugs” for non-clinical ailments that everybody has, like sometime anxiety or difficulty sleeping under stress, rather than treat actual ailments with actual medicine that would only reach a limited market (the sick).
Anyway, I hope this board puts human interest at the forefront when it makes its selections. Another problem with our healthcare system is that profit, not utility, governs what is covered in a for-profit healthcare plan, and HMOs have an incentive to deny as much care as they can under existing prices. So, simply a new definition of what medicines and procedures warrant coverage would be refreshing. As it happens, the sick are presently the worst off in our healthcare system (besides, you know, being sick), as they tend to be “uninsurable” and most likely to be denied coverage due to technicalities.
What’s in it for me? Well, as I understand, most nations with universal healthcare cover treatment for transsexuality. As it happens, gender identity disorder is in the DSM IV and has been an established condition in medical literature for decades, and the international medical consensus is that it should be treated with therapy and, if the patient so chooses (and if it is right for the patient), physical transition with hormones and surgery. It’s time to bring the US up to international standards in this regard!
As soon as this board forms, your mission, my fellow transgender people and allies, is to press for this it to give the standard medical procedures for gender identity disorder its formal endorsement. It would be an enormous step toward making sure transsexuals live full, productive, happy lives, that we live for our potential, that we contribute our full extent to the economy, and that young trans children are not tempted to go into sex work solely to pay for their healthcare, or are forced to choose between their health and a college education. It would be a weight from our shoulders, a blessing in our lives, a decades-overdue gesture of recognition, and the start of transsexuality finally being something normal in society. It would mean the world to me.