Wednesday, January 20, 2010

"Move quickly to coalesce..."

In the wake of the MA disaster, Obama sez, vis-a-vis health care:
I would advise that we try to move quickly to coalesce around those elements of the package that people agree on.
By "people" he means the insurance industry and Republicans. I suspect that everyone is going to coalesce around the idea of mandates. And everyone will coalesce around the concept of not forcing the industry to pay for people who are actually ill.
"We know that we have to have some form of cost containment..."
Nothing in the present bill contains cost. Folks in single-payer countries pay far less per capita for health care than we do. Single-payer would have lopped 30% off of costs like that, but Obama made sure that single-payer was a non-starter. And the Dems in Congress made sure that there would be no drug re-importation from Canada, an idea that John McCain favored.

So how are we going to contain costs? Near as I can tell, the only method of cost containment that "everyone" (defined as the insurance industry and the Republicans) can "coalesce" around will be not providing coverage. Recission. Not covering people with pre-existing conditions. Cutting back on all sorts of actual health care.

But at least we won't be living the British nightmare, thank god.

And here's another idea we'll soon "coalesce" around: Gutting Social Security and Medicare!


Perry Logan said...

You are right, sir!

This will all be the Clintons' fault soon.

Augusto Del Gracio said...

And it should be his falut, after all he is a racist, Cracker!

Joe you are absolutely right, cost containment will mean no treatment for the sick. Voila! Problem solved. Much easier than single payer-- my mom in Quebec has sciatica, something I know you can understand. She get's a patch with morphine (one more reason that I really feel for your pain), you know what she pays for it? $50 a month, that's the cap on Quebec's pharma plan. She's actually now starting an experimental plan where they're going to inject her with some painkiller that she will only need once every two months, also paid for by the Provincial gov. Thank god you don't have to endure such hells.

...although one interesting play i do think obi is behind, that is a slight variation on an old commie trick--- when things sucked in Russia or East Berlin, when there was no food on the shelves, the one thing you could always be sure of was vodka, cigarettes (and beer in the Demokratische Republik) and cigarettes. No matter what, people could feed their jones, get a buzz and forget about how much everything sucked. And now DC has "medicinal" marijuana dopenarie (that was a typo but i'm keeping it in) as does Denver (like mad) and in your LA i hear the ratio of dispensaries to Starbucks is now 3:1 I am certain that this is Obi's plan-- unlike in canada where you get a med. marij. permit if you have AIDS or Cancer or a few other major issues, in the new and improved USA you can get a permit for headaches, back pain, the munchies, just about anything. See where this is going? I'm not saying cannabis is want for medicinal qualities. I mean, back before the Marijuana Tax Act about 2/3 of a doctors black bag was cannabis salves, tinctures, drops... but what is going on now is an attempt to get everyone 'blunted' ...get 'em stoned, complacent, and lethargic. Move over doctors, hospital, clinics and HMO and say hello to the Ganja Gourmet (coming soon, the Ganja Soup Kitchen & Bread Line?)

Anonymous said...

I've mentioned it before, but I'll repeat it. It has bipartisan support in that Newt Gingrich had talked it up enthusiastically in spring of '09.

The Mayo Clinic has demonstrated a 'best practices' model that projects out to some $90 billion in annual savings for the system by reducing hospital care-caused infections, and reducing the need for costly re-hospitalizations. It's mostly better hygiene, closer to what is now only done in quarantine conditions. The medical profession objects to adopting these enhanced procedures, claiming what they do is fine, just as it took a generation to get them to wash their hands before surgery.

A neglected strength of the Senate bill was its requirement that something like 85% of expenditures of insurance companies went to providing care reimbursement. Compared to the current rake-off of 30% for overhead, marketing, and profit, this increases by over 20% the care provided for a given dollar passing through the insurance system.

And it only makes sense to make medical records electronic and cross-compilable among providers. Medicine conflicts will be avoided, allergies will always be known, and there will be an incomparable epidemiological database from which to research comparative effectiveness issues.

There are many obvious areas of efficiency, whereby reduced spending does not result in decreased or rationed care. Moreover, the current system itself rations by ability to pay, costing nearly 1,000 deaths thereby every week. (That Harvard study said it was 44,000 a year.)

More dead every three weeks than were killed in 9/11. Year after year, and it's getting worse each year.

The doubling of the national health care expense over the past 10 years saw the only 10 year period in history for which the median real wage was flat. All productivity gains of the workforce resulted in no higher wages because of the doubled cost of health care to their employers. This is an unsustainable situation, but still the medical inflation rate gallops along at a 9% annual increase, with its pass-throughs to employers paying for insurance.

So of course we must trim the projected rise in health care costs. It does liberals no credit to oppose any cut in projected future expenditures because such cuts are absolutely necessary as national policy. Even if Obama is one of those saying it. (At the current rate of increase, in not so many years, the projected health care costs for Medicare and Medicaid will consume the entire projected revenues of the federal government.)


Gary McGowan said...

The HMO medical services companies set up by Nixon & co. in 1973 exist not to provide care, but to use legitimate health care services as an excuse to sell insurance.

Overhead costs are 30-plus percent of all healthcare costs, as opposed to some 3% overhead for what we used to have under the (pre-Nixon) Hill-Burton system.

Malpractice insurance has served to protect the HMOs. Key to this was the 1974 Employment Retirement Security Act, which held that HMOs were providing interstate health services so they could not be sued under state law; and HMOs could not be sued under Federal Law because under the ERISA the HMOs were just administering benefits programs and not implementing medical treatment directly.

So… the only recourse a patient-victim of malpractice in an HMO-based system had was to sue the doctors, and there followed many such suits. So the insurance companies raked in more loot from the doctors with malpractice premium hikes. Doctors were stressed trying to protect their practices when it was the HMOs that should have been put out of business.

Malpractice suits declined, but insurance companies still raised rates. Doctors and treatment facilities were slammed from both sides; HMO pressures to limit care, and the unaffordability, or even unavailability of malpractice insurance.

During the early GW Bush administration, physicians in some states faced rates which had risen 70% in a few years —some faced premiums of over 100% of their income. In 2001 the American Hospital Association reported that malpractice rate hikes forced 20% of U.S. hospitals to cut back services; nursing homes were hit hard. This process has been continuing and worsening.

The point is that this HMO system keeps people from getting care they need and prevents doctors from providing services. This is denial of care, it is morally criminal and has nothing to do with rational economics. This is how the scum in DC say we are going to reduce costs—by continuing and increasing this system of looting and austerity.

This legislation was virtually written by the insurance companies and the likes of Peter Orzag and Ezechial Emanuel. It’s going to set up an appointed board unaccountable to citizens or elected representatives which will decide who will get medical care and who will be refused medical care. The poor, in predominately black and Hispanic areas, for example, will have money shifted out of their areas and to the so-called “more efficient” hospitals. No mammograms is just a start. Not being able to get an ambulance to a woman delivering a baby is just a start.

So who benefits? AIG, which insures all of this. Via the AIG bailout swindle, we support those who make health care unaffordable, and deny care altogether in their very lucrative scam AND AIG created a huge debt which our—and our children’s name has been signed onto. No wonder Secretary of the Treasury Tim Geitner tried to cover up AIGs operations when he was heading the NY Federal Reserve. They knew exactly what they were up to. Looting the American people.

Nothing short of bankruptcy reorganization will solve this economic crisis, and nothing short of a Hill-Burton type standard is a sane solution to a system of public healthcare.

If we dispersed all those trillions of dollars via the states and counties to rebuild the Hill-Burton system, and let medical professionals instead of bean-counters and behavioral economists improve the public health system and told all the derivative-sellers to eat their self-made weapons of mass destruction, THAT would be sane.