Impeding changes to our Health Care system

[TheMercenary]

Reid dives at the chance..

Senate Leader Takes Risk Pushing Public Insurance Plan

By ROBERT PEAR and DAVID M. HERSZENHORN
Published: October 22, 2009
WASHINGTON — In pushing to include a government-run health insurance plan in the health care bill, the Senate majority leader, Harry Reid, is taking a calculated gamble that the 60 members of his caucus could support the plan if it included a way for states to opt out.

http://www.nytimes.com/2009/10/23/he...h.html?_r=1&hp

I don't know why they don't just put their plan on the table and go for it. The Demoncrats want a public option and they want a single payer system in the end. Why be subversive about it? Put it out there and let the voters tell them what they think about it in the next election.

[TheMercenary]

Commentary
Why Doctors Are Worried
Marc Siegel, 10.22.09, 2:00 PM ET

I sit before my aging patient Julia for a few moments before my office nurse bangs on the door to say I'm running late. Julia looks at me across the desk, and in her pleading eyes, I can see her hopes for a reassurance or a cure. She hopes that I will tell her that nothing is wrong, or if there is something, that I can immediately fix it.

She is not thinking about health insurance reform. She is not worrying that the government is plotting to spread expensive insurance to pay for low-tech care for the entire population. She hopes only that her card will cover her in the case of illness. She is far more concerned about losing her connection with me and my network of doctors than she is about whether health insurance is extended to more people.

Thinking about her and those like her makes me very angry. Should I tell her that the very art of medicine that I rely on to take care of her is in mortal jeopardy? I barely have enough time with my growing list of patients to concentrate on her case as it is, and the reform will bring me more patients with lower payments. Should I mention that many of my contemporaries (the network she relies on) are no longer accepting her Medicare, even before the reform bills sink their claws into it and cut Medicare to the bone with hundreds of billions in cuts?

Should I say that primary care doctors like me already designate an employee to deal entirely with insurance, and that this problem will only get worse as we move in the direction of comparative effectiveness studies and bundling payments based on so-called quality? I lay awake at night thinking of the services I will deliver only to be denied payment.

The orthopedist I referred Julia to for her total hip replacement received only $970 for the procedure, and he says he hates to operate now because he loses an hour before and after each operation getting ready and cleaning up. If his payments drop further or his malpractice premiums rise higher, he vows to work only in the office and avoid the operating room altogether. Who will operate on patients like Julia then?

The organization that supposedly represents us, the spineless American Medical Association, has sold its soul to health reform in return for a one-year moratorium on the legislated, across the board 21% Medicare cuts that are always hanging over our heads. This feels too much like Kafka's In the Penal Colony, where our terrible future is written on our bodies in indelible ink. Every practicing doctor I know is worried about this future.

Increasing government oversight will not only hurt doctors in the pocketbook, as reimbursements are inevitably cut. It will also lead to greater bureaucratic inefficiencies. There will be more paperwork, less approvals and less time for cures.

Today, my patient Julia is wondering where the H1N1 swine flu shot is; it was supposed to be here weeks ago. I don't have the heart to tell her that since the Centers for Disease Control and the state health departments took over distribution a few weeks ago, it is nowhere to be found. I have filled out form after form, applied for new ID numbers, and still I can't get on the right list to receive the shot.

This is the future. And as the Baucus bill glided through the Senate Finance Committee last week, I can see that the future is here.

http://www.forbes.com/2009/10/22/doc...gel_print.html

[Urbane Guerrilla]

They're being subversive, or better obscurantist, about it the better to slip it by.

These are the people Redux is such a big fat fan of.

This is why sensible people stop voting Democrat, in some cases since sometime in the previous century.

Passage of a "healthcare" bill that is unwritten, and much more productive of dependency upon the public sector, the State, than it ever will be of healthcare or even medical coverage, will make it imperative that I never vote for a Democrat for any office in any place for the rest of my days. It just offends my Libertarian principles -- government should never be confused with a service industry, for it cannot function well that way. The Democrats do not understand this, while the Libertarians do. The Republicans -- they're a bit more amenable to libertarian logic, and the conservatives particularly so. Incidentally, none of the, um, plans will cover any more people than are actually chronically not covered now, somewhere between ten and twenty-five millions rather than the forty-seven million figure bandied about by the vehemently Statist, [capitalization intended] and they have openly said as much. Wow, such achievement! The 10M-25M estimate is made fuzzy primarily because of the "illegal aliens not covered" estimates. They are not precisely known, only quite imprecisely -- lack of data.

The health insurance market is at present unhelpfully regulated. By law, insurance companies are kept confined to given states, which measure is monopolistic. It takes only partial economic literacy to be aware of how unfortunate monopolies are for the economy that must contain them. Better not to. Lose the monopolistic -- government-created and government-imposed -- measures, and watch the efficiencies of the free market go right to work. Deregulation worked just fine for the airline industry once their lobbyists stopped whining. (Yeah, I know about the rags where there should have been screw caps. Doing well for twenty years doesn't absolutely guarantee you'll do well the twenty-first -- but which way would you bet? And how fast do problems that come to public light get corrected?)

There is no such thing, sayeth the Libertarian Party, as a natural monopoly. The case they make for their argument is pretty robust. It would, I think, be enlightening to take a look at it. Why, for instance, did people so often grouse about their cable service? The law, not the inherent nature of the telecommunications industry, tried to hedge cities about with only a single cable provider. Were the results any good from a content or service point of view?

There is the matter of tort reform, specifically limiting damages recovery from astronomical stakes to something less like hitting the lottery on Super Ultra Mega Powerball. This is intended to reduce exorbitant medical malpractice rates, which allows doctors to prosper once again, which indirectly benefits their patients, as doctors can either reduce fees, or confine them to covering, well, more rational cost figures. Medicine is not immune to Adam Smith. Stop making it attractive to the lottery-players, both within and without of the U.S. legal profession.

[TheMercenary]

The lack of transparency continues.

Originally published 04:45 a.m., October 26, 2009
updated 04:51 a.m., October 26, 2009
Health reform written behind closed doors

Jennifer Haberkorn

By day, Democrats tout how open they have been while crafting a bill to reform the nation's health care system. By early evening, they're behind closed doors.

Three times last week, White House officials went to Capitol Hill to meet in closed sessions with top Senate Democrats to put together a health bill. They left with not much more than a thumbs up or a "we're making progress"-type comment to the reporters waiting outside.

It's not exactly the level of transparency that President Obama promised during the campaign, when he said health care talks would be aired live on C-SPAN.

"I'm going to have all the negotiations around a big table," he told a town hall audience in Chester, Va., in August 2008. "We'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think, is what is going to allow people to stay involved in this process."

The small group of White House officials and three senators met in Senate Majority Leader Harry Reid's office three evenings last week to discuss what kind of bill to send to the Senate floor. The negotiation team includes Mr. Reid, Finance Committee Chairman Max Baucus of Montana, and Christopher J. Dodd of Connecticut, who led the work on the Health, Education, Labor and Pensions (HELP) Committee bill.

White House officials seen leaving the meetings include Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius, health care "czar" Nancy-Ann DeParle, and Peter Orszag, director of the Office of Management and Budget.

It's hardly unexpected that major legislation on Capitol Hill, particularly on an issue as complex as health care reform, would be done in a small group and behind closed doors. The reform debate is now at a particularly sensitive stage, as House and Senate leaders have to make major political and policy decisions on what kind of legislation to send to their chambers' floors.

But Mr. Obama's campaign promises have provided Republicans and other opponents of the Democrats' reform plans with an easy criticism of how he's crafting the legislation.

"They're writing a health care bill in secret, even though the president called for all of this to be out on an open table and have C-SPAN cameras in the room," House Minority Leader John A. Boehner of Ohio said last week.

"We're about to significantly alter one-sixth of the economy, and if there was ever a need for transparency it is now," Sen. Mike Johanns of Nebraska warned in a recent Republican address.

Rep. Mike Pence of Indiana, chairman of the House Republican Conference, has made repeated reference to the health care debate moving "into the smoke-filled rooms" of the Capitol. (Though technically smoking has been banned in the public spaces of the Capitol for two years.)

Mr. Obama argued in a January 2008 Democratic debate that transparency would ensure that special interests couldn't overtake the reform bill.

"If the drug companies or a member of Congress who's carrying water for the drug companies wants to argue that we should not negotiate for the cheapest available price on drugs, then I want them to make that argument in front of the American people," he said.

When asked in a July press conference about the level of transparency, Mr. Obama defended the process.

"You will recall in this very room that our kickoff event was here on C-SPAN and, at a certain point, you know, you start getting into all kinds of different meetings," Mr. Obama said. "Senate Finance is having a meeting; the House is having a meeting. If they wanted those to be on C-SPAN, then I would welcome it. I don't think there are a lot of secrets going on in there."

A White House official did not return a request for comment Friday.

Senate Democrats involved in the conversations defended their process. After the discussions in Mr. Reid's office, one of the lawmakers or spokesmen have given reporters a broad outline of what topics were discussed. Last week, they talked about the employer mandate and the public option.

Mr. Dodd, who led the health bill through the HELP Committee as a stand-in for then-ailing Sen. Edward M. Kennedy, defended the process.

"The suggestion, somehow, that this is being done otherwise is just blatantly false and a distraction from what, really, we need to be talking about, and that is what's in these bills, what are we trying to achieve?" he said.

The Finance Committee posted its overhaul legislation and proposed amendments on its Web site, and its mark-up sessions were aired on C-SPAN and the Internet.

"The Finance Committee, the HELP Committee, there were countless hearings, all public, all in the open," Mr. Baucus, chairman of the Finance Committee, told reporters.

"I have not been involved in such an open and transparent process as this, and I'm very, very proud that we've done it," Mr. Baucus said. "We embarked on this process because it's the right thing to do, but also to help give senators the comfort that we had a good idea of what it is that we're doing."

http://washingtontimes.com/news/2009...home_headlines

[TheMercenary]

Well Harry finally pulled the trigger. It is about time. I seriously doubt he ever considered not including it but he just didn't have the balls to admit it since he is doing so poorly in his home state and next year he is up for election. I figure he just sees the writing on the wall and if he is not re-elected it will be a hard long fall from grace for him.

Harry pulls the trigger:
Reid announced today that he’s backing the inclusion of a public option in the Senate’s healthcare legislation.

http://latimesblogs.latimes.com/wash...-politics.html

[TheMercenary]

An interesting report. I would like to see more about how they arrived at their numbers. I believe much of it sounds plausible.

Healthcare system wastes up to $800 billion a year

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - The U.S. healthcare system is just as wasteful as President Barack Obama says it is, and proposed reforms could be paid for by fixing some of the most obvious inefficiencies, preventing mistakes and fighting fraud, according to a Thomson Reuters report released on Monday.

The U.S. healthcare system wastes between $505 billion and $850 billion every year, the report from Robert Kelley, vice president of healthcare analytics at Thomson Reuters, found.

"America's healthcare system is indeed hemorrhaging billions of dollars, and the opportunities to slow the fiscal bleeding are substantial," the report reads.

"The bad news is that an estimated $700 billion is wasted annually. That's one-third of the nation's healthcare bill," Kelley said in a statement.

"The good news is that by attacking waste we can reduce healthcare costs without adversely affecting the quality of care or access to care."

One example -- a paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending.

"It is waste when caregivers duplicate tests because results recorded in a patient's record with one provider are not available to another or when medical staff provides inappropriate treatment because relevant history of previous treatment cannot be accessed," the report reads.

Some other findings in the report from Thomson Reuters, the parent company of Reuters:

* Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.

* Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.

* Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.

* Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.

* Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.

"The average U.S. hospital spends one-quarter of its budget on billing and administration, nearly twice the average in Canada," reads the report, citing dozens of other research papers.

"American physicians spend nearly eight hours per week on paperwork and employ 1.66 clerical workers per doctor, far more than in Canada," it says, quoting a 2003 New England Journal of Medicine paper by Harvard University researcher Dr. Steffie Woolhandler.


Yet primary care doctors are lacking, forcing wasteful use of emergency rooms, for instance, the report reads.

All this could help explain why Americans spend more per capita and the highest percentage of GDP on healthcare than any other OECD country, yet has an unhealthier population with more diabetes, obesity and heart disease and higher rates of neonatal deaths than other developed nations.

Democratic Senator Charles Schumer said on Sunday that Senate Democratic leaders are close to securing enough votes to pass legislation to start reform of the country's $2.5 trillion healthcare system.

http://www.reuters.com/article/healt...BrandChannel=0

[ZenGum]

$800 billion? Holy moolah! You could invade Iraq for that kind of money.

[Shawnee123]

And stop for burgers afterwards!

[Radar]

Originally Posted by ZenGum

$800 billion? Holy moolah! You could invade Iraq for that kind of money.

No, Iraq costs way more than that. But hey, look at all the <sarcasm>wonderful</sarcasm> things that have come out of it. Thousands of dead Americans, tens of thousands crippled and maimed. Millions of Iraqi people displaced. Hundreds of thousands of Iraq people murdered, tortured, and imprisoned who did nothing illegal, embarrassing America throughout the world, etc.

[classicman]

...well thats one view.

[Radar]

Originally Posted by classicman

...well thats one view.

Yes. The right one.

[classicman]

Keep telling yourself that. Perhaps one day.
While you're here I'll have one with mustard and a lil onion.

[spudcon]

How about the trillions in Obamas giveaways? We could even fight a war in Afghanistan with that. Oh, wait, we've got to think about it for a few months.

[Spexxvet]

Originally Posted by spudcon

How about the trillions in Obamas giveaways? We could even fight a war in Afghanistan with that. Oh, wait, we've got to think about it for a few months.

Better than jumping in asshole first, quick like a bunny, for no good reason. It was Bush's fault.

[classicman]

Perhaps, only time will tell.