Based on his wildly successful campaign alone, one would have to concede that President Obama and his progressive cohorts are skilled political tacticians. It may be less obvious that they are also world-class political strategists.
Take the recently passed Obamacare bill as an example. On many occasions, the President and the Democrat leadership have clearly stated that their primary goal is nationalized health care (also called “single-payer system”, and “socialized medicine”). In fact, nationalized health care was often described as the core provision in the proposed health care reform bills – progressives like Congressman Dennis Kucinich threatened to vote against the bill unless it contained nationalized health care. But, nationalized health care ran into stone walls in Congress, so the progressives dropped the provision, ostensibly because any version of Obamacare was better than none – a seemingly wise tactical move.
The bill that finally passed is more than 2,700 pages long, incredibly complex, and contains many controversial provisions, but it does not contain nationalized health care ... or does it? Doesn’t it seem strange that people as committed and successful as Obama/Pelosi/Reid gave up on their primary goal? In fact, they did no such thing. What they really did was employ a brilliant strategy to slip nationalized health care in under the radar. Here’s how they did it.
We begin with the health care bill’s seemingly innocuous and just provision that insurance companies can no longer deny coverage to anyone because of pre-existing conditions. Who wouldn’t be in favor of that? Even many Republicans support this notion. (Never mind that it flies in the face of all business logic - imagine calling an insurance company to buy coverage for your wrecked car or your house that just burned down.)
The second provision to consider is that everyone will be required to have health insurance – universal participation. Those who refuse to buy health insurance will be fined. Requiring Americans to buy something is of course highly controversial and even unconstitutional in the eyes of many. The Obama camp cleverly responded to these arguments by explaining that universal participation would mean more customers for insurance companies and therefore lower premiums for everyone. They emphasized that approximately half of the currently uninsured people in this country choose not to buy health insurance because they are healthy; and, since Obamacare will require these healthy folks to buy health insurance, the insurance companies will gain more than 10 million new, healthy, and therefore profitable, customers. Seems like a win-win, except of course for the 10 – 15 million reluctant participants who will be forced to buy insurance they don’t want.
Enter the third, and last provision we must consider: to soften the blow for these reluctant participants, the fines for refusing to participate are relatively low. Individuals who refuse to participate will pay an annual fine of $695 or less, and families who refuse will pay a maximum of $2,085. Compare these amounts to conservative estimates of the average annual cost of health insurance: around $4,000 for an individual and $10,000 for a family. The health insurance costs 5 times more than the fines. Obviously, most of the healthy uninsured folks won’t be new insurance company customers after all – financially, they’ll be way better off to pay the fines.
Now, recall the Obamacare provision that insurance companies cannot deny coverage because of pre-existing conditions. This means you can choose to pay the fines at absolutely no risk, because you can always buy the health insurance after you get sick or injured. Holy smoke and mirrors! What if all the other healthy individuals and families – those that are currently insured - choose to do the same thing?
Well, let’s see. Health insurance companies stay in business because the insurance premiums paid by healthy customers exceed the claims made by sick or injured customers. But, under Obamacare, it is financially prudent for healthy people to pay the fines and avoid buying health insurance until after they are sick or injured. So, the only remaining insurance company customers will be the sick or injured. Without the premiums from healthy people to offset the cost of claims, the insurance companies will go broke.
And what will happen then? Why, our benevolent progressive government will bail out the insurance companies and take them over. Presto chango: we have nationalized health care/single-payer/socialized medicine. Wow! Wasn’t that the core goal of President Obama and his progressive friends in the first place – the goal that they ostensibly tactically abandoned?
Now that’s what I call a great strategy. The progressives’ first tactic was to abandon the most controversial provision: nationalized health care. Then by proposing a huge, hopelessly complicated, multi-thousand page plan filled with many controversial provisions, the progressives diverted attention and focused the national debate on many other obviously controversial issues – another really clever tactic that was critical to the success of the overall strategy. Even if the President and the progressives lost a few of the battles over some of these controversial issues, the strategy moved forward because all they really needed was coverage of pre-existing conditions and relatively low fines for not having health insurance coverage. Any other provisions that remained in the bill were pure gravy, because these two provisions alone will inevitably lead to nationalized health care.
Here’s the bottom line. Unless we somehow manage to repeal Obamacare, America will soon have nationalized health care/single-payer system/socialized medicine, and the government will have taken over (nationalized) one of America’s largest industries. We’ve been had by the biggest con in American history.
Showing posts with label Health Care Issues. Show all posts
Showing posts with label Health Care Issues. Show all posts
29 March 2010
04 October 2009
Regarding The Fair Tax
I may have lost part of my mind, but, thank God I still have a wife. Ginny reminded me that, in The Fair Tax piece, I forgot to mention that the economists have calculated the 23% rate as exactly revenue neutral. In other words, the 23% Fair Tax would generate the same income as all those other federal taxes that will be eliminated combined. Naturally, the percentage would be revisited as part of the federal legislative process, just as all the other tax rates are now.
28 September 2009
Letter From an MD on Proposed Health Care Reform
Hi folks,
I personally called the number listed in this letter and confirmed that the letter is genuine and that the author is an MD. I commend it to you all.
For my own comments on health care issues, simply click on "health care issues" at the end of Dr. Hess' letter.
Joe
September 23, 2009
Representative Ann Kirkpatrick
1123 Longworth House Office Building
Washington, DC 20515
Dear Congresswoman Kirkpatrick:
Over the past few months I have followed with great interest the debate about health care that has been unfolding in Washington, D.C. My interest led me to read HR 3200 in its entirety. The 1000 plus page House bill is a convoluted legal document that I suspect even my good friends at Arent & Fox LLP on K Street don’t understand.
Being both board certified in Internal Medicine and in Cardiovascular Disease and having practiced in both the academic and private sectors, I feel that I have some knowledge related to the issues that have been debated. In addition, my wife, Pamela Jones, holds a Master Degree in Healthcare Management from Duke University and has over twenty years of healthcare experience, consulting with large hospital systems and physician groups. Our collective observations and opinions are outlined below:
1. "Primum non nocere" – At the time a medical student examines his first patient, he is reminded constantly of the wisdom: “First do no harm”. It is a warning that Congress should itself heed. It is unfathomable to me that those in Congress believe they have the knowledge, experience, and wisdom to completely overhaul the manner in which payment for medical services is provided. This is especially appalling when, in fact, few in Congress have any medical experience what so ever. For instance, Senator Max Baucus of the Senate Finance Committee, is an attorney, with no experience in providing direct medical care or in working in the medical industry (such as a hospital administration, health insurance, pharmaceuticals, etc.) Yet, despite this lack of ‘hands on’ experience, Senator Baucus has just released a healthcare proposal every bit as overreaching as the ones currently in the House. Whenever I am asked what I think of the Congress ‘overhauling’ healthcare, I tell people: “It would be like having a group of cardiologists overhauling the air traffic control system of America. Would you want that to happen?”
Representative Ann Kirkpatrick
September 23, 2009
Page Two
The fact that Congress has undertaken such an endeavor in an expedited manner indicates to me a degree of hubris that is unlike any I have ever witnessed. By proceeding in this fashion Congress will undoubtedly produce an outcome far worse than the original problem itself.
2. Law of Unintended Consequences – Everyone agrees that there are issues related to the affordability, portability, and accessibility of health insurance. But what no one knows or can predict is the consequences of the proposals now before Congress. Why would the members of Congress believe they could create major changes to 17% of the nation’s economy and perfectly predict the outcome one will get – the outcome as to cost of care, quality of care, and accessibility of care?
Just for discussion lets take the issue of accessibility of care. Using the president’s estimates of 30 to 45 million uninsured people, what will happen when they suddenly have access to care? There are not enough doctors, nurses, or allied healthcare personnel to care for a 10 to 15% increase in patient volume. Yet, nowhere in the discussed proposals is this question addressed. It takes ten or more years to change the medical educational system to produce more physicians. Recently, when this ‘manpower shortage’ was questioned in the media, those in favor of a major overhaul have argued that there would be no major increase in utilization because the majority of the uninsured are young and healthy. If that is the case, why is it a crisis to change healthcare in such a rush to insure these healthy youngsters?
We caution you that the proposed changes are draconian and no one can predict the resulting outcome. However, based on prior Congressional programs one can predict that if a program is ‘passed’, it will be more costly and less effective than predicted.
3. American Medicine Exceptionalism – Why care if the proposed programs are not perfect? The answer to that question is hopefully clear to Washington: The United States is universally regarded as having the most advanced medical care in the world. There is a reason that more than 400,000 foreigners travel to the United States each year to undergo treatments and procedures. Radically changing a successful system is risky business, but Congress seems oblivious to the risks involved. America is the incubator from which medical advancements hatch. Just to name a few such ‘breakthroughs’:
Representative Ann Kirkpatrick
September 23, 2009
Page Three
In 1987, Dr. Eddie Joe Reddick, a private practice general surgeon in Nashville Tennessee, performed the first laparoscopic removal of a gallbladder, paving the way for the field of minimally invasive surgery. In 1985, patients undergoing gallbladder surgery were usually hospitalized for 5 to 10 days and were off from work for 4 to 6 weeks. In 2009, the same surgery is performed as an outpatient and most patients are back to work in less than a week. Dr. Reddick’s technique radically changed the way surgeons approached many surgical problems. A new approach that produced improved outcomes and significant cost savings to society. The rest of the world then followed our example.
In 1981, Dr. John Simpson, a private practice cardiologist in California, invented the ‘movable guidewire’ for coronary angioplasty catheters, thus revolutionizing our approach to the treatment of coronary artery disease. Something that once required open-heart surgery, a prolonged hospitalization, and weeks away from work, could suddenly be treated with a simple catheter procedure, a one-day stay in the hospital, and only a few days away from work. A new approach that produced improved outcomes and significant cost savings to society. The rest of the world then followed our example.
Drugs classified as ‘statins’, that lower cholesterol remarkably and have resulted in significantly lower mortality rates from heart disease, were developed in the United States. Americans have better access to these ‘wonder’ drugs than European patients. In the U.S. 56% of patients who would benefit from a statin drug are taking such a drug, whereas only 36% of Dutch, 29% of Swiss, and 23% of Britons are receiving them. Not only did America make this ‘breakthrough’ in heart disease prevention but has also proven more effective in disseminating the treatment to those who will most benefit from it.
American advances in the treatment of heart disease are producing dramatic reductions in mortality. In 1970 the death rate from heart disease in America was 448 per 100,000 population. In 1980 it was 345; in 1990 the rate was 250. By 2006 (the last year data are available) the death rate from heart disease was 135 per 100,000 population. One cannot merely view the increase in healthcare expenditures without evaluating the results produced by that expenditure. In heart disease care alone, there are 400,000 fewer deaths per year than there were in 1970. I would suggest that those saved by these new treatments and procedures would agree that the expenditures were well spent!
Representative Ann Kirkpatrick
September 23, 2009
Page Four
America sets the standard for cancer treatments. Breast cancer mortality is 52% higher in Germany than in the U.S. and 88% higher in Great Britain. The mortality rate for colorectal cancer patients is 40% higher in the United Kingdom than in the U.S. Why would we want to incorporate any aspects of health care from these European countries with inferior treatment outcomes?
During his treatment for malignant brain cancer, Senator Ted Kennedy received proton beam therapy at Massachusetts General Hospital, which spares viable tissue while attacking the cancerous tissue. It is only available to patients in the United States. The reason Senator Kennedy did not seek treatment overseas, is because the most advanced health care in the world is here in the United States.
There is no doubt that the proposals currently being debated in Washington will produce an end to the era of American Exceptionalism in Medicine – ask any doctor. The legacy of the 111th Congress will be the death of American Medical Exceptionalism if it passes any of the current health care proposals.
4. “Show me the Money” – The current proposals in Congress rely on savings generated from eliminating more than $500 billion in ‘fraud and abuse’ from the government’s Medicare and Medicaid programs. Every president and Congress since Nixon have made similar pledges, but you know what – the waste is still there. One does not have to pass a major ‘overhaul’ of health care to solve this problem. The government ‘owns’ Medicare and Medicaid – why not immediately begin to realize these savings if they can be identified and eliminated? If MasterCard and VISA can effectively control ‘fraud and abuse’ in their trillions of dollars in transactions yearly, why can’t the government do the same with a much smaller program? The reason the ‘fraud and abuse’ are still a part of those programs is the government does not have the expertise or technology to identify the ‘waste’.
Confidence in the government’s ability to manage a significant change in healthcare would be much greater if the government could demonstrate that it can fix the problems that currently exist in its present programs. Why not take the next two or three years and concentrate on the fraud and abuse in these government programs and prove to the American people the government can get results, not just make promises?
Representative Ann Kirkpatrick
September 23, 2009
Page Five
5. Inflammatory Rhetoric –The manner in which a proposed program is framed is an excellent indicator of the advocator’s beliefs. As a physician, I am terribly disturbed by the manner in which President Obama has characterized the medical profession. For the purpose of illustration I will give two such instances of this characterization:
• Portsmouth, New Hampshire August 11, 2009: Taken directly from transcripts of President’s Obama’s town hall meeting. President Obama states: “All I'm saying is let's take the example of something like diabetes, one of --- a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family -- if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money.” (Applause.)
• Press Conference, East Room, White House July 22, 2009: Taken directly from transcripts of President’s Obama’s press conference. President Obama states: “So if they're looking -- and you come in and you've got a bad sore throat, or your child has a bad sore throat or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, you know what, I make a lot more money if I take this kid's tonsils out. Now that may be the right thing to do, but I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change -- maybe they have allergies, maybe they have something else that would make a difference. So part of what we want to do is to free doctors, patients, hospitals to make decisions based on what's best for patient care.”
For expediency I have bolded and highlighted the portions of the president’s speeches to indicate the inflammatory manner in which he has categorized physicians. In the first example he has stated that a surgeon would receive $30,000 to $50,000 for performing an amputation – nothing
Representative Ann Kirkpatrick
September 23, 2009
Page Six
could be further from the truth. The customary surgeon’s reimbursement for such a procedure is from $600 to $800 dollars. Not even the total hospital bill would approach the numbers ‘thrown out’ by the President.
In the second example, the President implies that physicians take into consideration what they will be reimbursed in making clinical decisions and only places like the Mayo Clinic base decisions on “what is best for the patient.” This statement is a vicious attack on the ethical values of physicians and is so egregious it does not even deserve a comment.
The use of rhetoric like this has only one purpose, not to disseminate the facts but to distort them to obtain a goal – in this case the President’s vision of medical care. By demonizing physicians as ‘money grubbing’ individuals, the administration seeks to gather support from the public. My disappointment in the President is only exceeded by my disappointment that no one in Congress stood tall and said – those statements are wrong! Do not think that these statements were overlooked by the medical profession; every physician I have talked with about the healthcare issue spontaneously brings up these two examples.
6. Absolute False Statements: One can intelligently debate issues without purposefully giving false statements to embellish one’s argument. The most glaring example was during President Obama’s speech before Congress on September 9, 2009 when he gave examples of abusive actions by insurers. Mr. Obama referred to a man in Illinois who “lost his coverage in the middle of chemotherapy because his insurer found he hadn’t reported gallstones that he didn’t even know about. They delayed treatment, and he died because of it.”
According to Scott Harrington of the Wall Street Journal: the President’s conclusion is contradicted by the transcript of a June 16 hearing of industry practices before the Subcommittee of Oversight and Investigation of the House Committee on Energy and Commerce. The deceased's sister testified that the insurer reinstated her brother's coverage following intervention by the Illinois Attorney General's Office. She testified that her brother received a prescribed stem-cell transplant within the desired three- to four-week "window of opportunity" from "one of the most renowned doctors in the whole world on the specific routine," that the procedure "was extremely successful," and that "it extended his life nearly three and a half years."
Representative Ann Kirkpatrick
September 23, 2009
Page Seven
Why would the President use a false statement on a nationally televised speech? Do we have to distort the facts to win our position? Why demonize the insurance industry in a fashion similar to the way he has demonized physicians? One can only conclude that the healthcare debate is really about President Obama delivering on a major social issue and not about what is best for the average American who is quite satisfied with their own personal health insurance situation. Once again Washington is about who wins and who loses – the people have been forgotten.
It is my sincere hope that you will vote against any of the current health care proposals before Congress (or any iteration of the same) and seek a more reasoned, incremental approach to addressing the major issues related to insurance ‘one problem at a time’. In the interim, this Congress and administration can immediately demonstrate its commitment to reform by implementing processes that actual identify and eliminate the ‘fraud and abuse’ in the current government medical programs.
Should you wish to discuss these issues in more depth, I would be happy to discuss them with you by phone, (928) 771-0978 or in person. Thank you for taking the time to read this lengthy letter.
Yours sincerely,
David S. Hess, M.D., F.A.C.C.
I personally called the number listed in this letter and confirmed that the letter is genuine and that the author is an MD. I commend it to you all.
For my own comments on health care issues, simply click on "health care issues" at the end of Dr. Hess' letter.
Joe
September 23, 2009
Representative Ann Kirkpatrick
1123 Longworth House Office Building
Washington, DC 20515
Dear Congresswoman Kirkpatrick:
Over the past few months I have followed with great interest the debate about health care that has been unfolding in Washington, D.C. My interest led me to read HR 3200 in its entirety. The 1000 plus page House bill is a convoluted legal document that I suspect even my good friends at Arent & Fox LLP on K Street don’t understand.
Being both board certified in Internal Medicine and in Cardiovascular Disease and having practiced in both the academic and private sectors, I feel that I have some knowledge related to the issues that have been debated. In addition, my wife, Pamela Jones, holds a Master Degree in Healthcare Management from Duke University and has over twenty years of healthcare experience, consulting with large hospital systems and physician groups. Our collective observations and opinions are outlined below:
1. "Primum non nocere" – At the time a medical student examines his first patient, he is reminded constantly of the wisdom: “First do no harm”. It is a warning that Congress should itself heed. It is unfathomable to me that those in Congress believe they have the knowledge, experience, and wisdom to completely overhaul the manner in which payment for medical services is provided. This is especially appalling when, in fact, few in Congress have any medical experience what so ever. For instance, Senator Max Baucus of the Senate Finance Committee, is an attorney, with no experience in providing direct medical care or in working in the medical industry (such as a hospital administration, health insurance, pharmaceuticals, etc.) Yet, despite this lack of ‘hands on’ experience, Senator Baucus has just released a healthcare proposal every bit as overreaching as the ones currently in the House. Whenever I am asked what I think of the Congress ‘overhauling’ healthcare, I tell people: “It would be like having a group of cardiologists overhauling the air traffic control system of America. Would you want that to happen?”
Representative Ann Kirkpatrick
September 23, 2009
Page Two
The fact that Congress has undertaken such an endeavor in an expedited manner indicates to me a degree of hubris that is unlike any I have ever witnessed. By proceeding in this fashion Congress will undoubtedly produce an outcome far worse than the original problem itself.
2. Law of Unintended Consequences – Everyone agrees that there are issues related to the affordability, portability, and accessibility of health insurance. But what no one knows or can predict is the consequences of the proposals now before Congress. Why would the members of Congress believe they could create major changes to 17% of the nation’s economy and perfectly predict the outcome one will get – the outcome as to cost of care, quality of care, and accessibility of care?
Just for discussion lets take the issue of accessibility of care. Using the president’s estimates of 30 to 45 million uninsured people, what will happen when they suddenly have access to care? There are not enough doctors, nurses, or allied healthcare personnel to care for a 10 to 15% increase in patient volume. Yet, nowhere in the discussed proposals is this question addressed. It takes ten or more years to change the medical educational system to produce more physicians. Recently, when this ‘manpower shortage’ was questioned in the media, those in favor of a major overhaul have argued that there would be no major increase in utilization because the majority of the uninsured are young and healthy. If that is the case, why is it a crisis to change healthcare in such a rush to insure these healthy youngsters?
We caution you that the proposed changes are draconian and no one can predict the resulting outcome. However, based on prior Congressional programs one can predict that if a program is ‘passed’, it will be more costly and less effective than predicted.
3. American Medicine Exceptionalism – Why care if the proposed programs are not perfect? The answer to that question is hopefully clear to Washington: The United States is universally regarded as having the most advanced medical care in the world. There is a reason that more than 400,000 foreigners travel to the United States each year to undergo treatments and procedures. Radically changing a successful system is risky business, but Congress seems oblivious to the risks involved. America is the incubator from which medical advancements hatch. Just to name a few such ‘breakthroughs’:
Representative Ann Kirkpatrick
September 23, 2009
Page Three
In 1987, Dr. Eddie Joe Reddick, a private practice general surgeon in Nashville Tennessee, performed the first laparoscopic removal of a gallbladder, paving the way for the field of minimally invasive surgery. In 1985, patients undergoing gallbladder surgery were usually hospitalized for 5 to 10 days and were off from work for 4 to 6 weeks. In 2009, the same surgery is performed as an outpatient and most patients are back to work in less than a week. Dr. Reddick’s technique radically changed the way surgeons approached many surgical problems. A new approach that produced improved outcomes and significant cost savings to society. The rest of the world then followed our example.
In 1981, Dr. John Simpson, a private practice cardiologist in California, invented the ‘movable guidewire’ for coronary angioplasty catheters, thus revolutionizing our approach to the treatment of coronary artery disease. Something that once required open-heart surgery, a prolonged hospitalization, and weeks away from work, could suddenly be treated with a simple catheter procedure, a one-day stay in the hospital, and only a few days away from work. A new approach that produced improved outcomes and significant cost savings to society. The rest of the world then followed our example.
Drugs classified as ‘statins’, that lower cholesterol remarkably and have resulted in significantly lower mortality rates from heart disease, were developed in the United States. Americans have better access to these ‘wonder’ drugs than European patients. In the U.S. 56% of patients who would benefit from a statin drug are taking such a drug, whereas only 36% of Dutch, 29% of Swiss, and 23% of Britons are receiving them. Not only did America make this ‘breakthrough’ in heart disease prevention but has also proven more effective in disseminating the treatment to those who will most benefit from it.
American advances in the treatment of heart disease are producing dramatic reductions in mortality. In 1970 the death rate from heart disease in America was 448 per 100,000 population. In 1980 it was 345; in 1990 the rate was 250. By 2006 (the last year data are available) the death rate from heart disease was 135 per 100,000 population. One cannot merely view the increase in healthcare expenditures without evaluating the results produced by that expenditure. In heart disease care alone, there are 400,000 fewer deaths per year than there were in 1970. I would suggest that those saved by these new treatments and procedures would agree that the expenditures were well spent!
Representative Ann Kirkpatrick
September 23, 2009
Page Four
America sets the standard for cancer treatments. Breast cancer mortality is 52% higher in Germany than in the U.S. and 88% higher in Great Britain. The mortality rate for colorectal cancer patients is 40% higher in the United Kingdom than in the U.S. Why would we want to incorporate any aspects of health care from these European countries with inferior treatment outcomes?
During his treatment for malignant brain cancer, Senator Ted Kennedy received proton beam therapy at Massachusetts General Hospital, which spares viable tissue while attacking the cancerous tissue. It is only available to patients in the United States. The reason Senator Kennedy did not seek treatment overseas, is because the most advanced health care in the world is here in the United States.
There is no doubt that the proposals currently being debated in Washington will produce an end to the era of American Exceptionalism in Medicine – ask any doctor. The legacy of the 111th Congress will be the death of American Medical Exceptionalism if it passes any of the current health care proposals.
4. “Show me the Money” – The current proposals in Congress rely on savings generated from eliminating more than $500 billion in ‘fraud and abuse’ from the government’s Medicare and Medicaid programs. Every president and Congress since Nixon have made similar pledges, but you know what – the waste is still there. One does not have to pass a major ‘overhaul’ of health care to solve this problem. The government ‘owns’ Medicare and Medicaid – why not immediately begin to realize these savings if they can be identified and eliminated? If MasterCard and VISA can effectively control ‘fraud and abuse’ in their trillions of dollars in transactions yearly, why can’t the government do the same with a much smaller program? The reason the ‘fraud and abuse’ are still a part of those programs is the government does not have the expertise or technology to identify the ‘waste’.
Confidence in the government’s ability to manage a significant change in healthcare would be much greater if the government could demonstrate that it can fix the problems that currently exist in its present programs. Why not take the next two or three years and concentrate on the fraud and abuse in these government programs and prove to the American people the government can get results, not just make promises?
Representative Ann Kirkpatrick
September 23, 2009
Page Five
5. Inflammatory Rhetoric –The manner in which a proposed program is framed is an excellent indicator of the advocator’s beliefs. As a physician, I am terribly disturbed by the manner in which President Obama has characterized the medical profession. For the purpose of illustration I will give two such instances of this characterization:
• Portsmouth, New Hampshire August 11, 2009: Taken directly from transcripts of President’s Obama’s town hall meeting. President Obama states: “All I'm saying is let's take the example of something like diabetes, one of --- a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family -- if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money.” (Applause.)
• Press Conference, East Room, White House July 22, 2009: Taken directly from transcripts of President’s Obama’s press conference. President Obama states: “So if they're looking -- and you come in and you've got a bad sore throat, or your child has a bad sore throat or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, you know what, I make a lot more money if I take this kid's tonsils out. Now that may be the right thing to do, but I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change -- maybe they have allergies, maybe they have something else that would make a difference. So part of what we want to do is to free doctors, patients, hospitals to make decisions based on what's best for patient care.”
For expediency I have bolded and highlighted the portions of the president’s speeches to indicate the inflammatory manner in which he has categorized physicians. In the first example he has stated that a surgeon would receive $30,000 to $50,000 for performing an amputation – nothing
Representative Ann Kirkpatrick
September 23, 2009
Page Six
could be further from the truth. The customary surgeon’s reimbursement for such a procedure is from $600 to $800 dollars. Not even the total hospital bill would approach the numbers ‘thrown out’ by the President.
In the second example, the President implies that physicians take into consideration what they will be reimbursed in making clinical decisions and only places like the Mayo Clinic base decisions on “what is best for the patient.” This statement is a vicious attack on the ethical values of physicians and is so egregious it does not even deserve a comment.
The use of rhetoric like this has only one purpose, not to disseminate the facts but to distort them to obtain a goal – in this case the President’s vision of medical care. By demonizing physicians as ‘money grubbing’ individuals, the administration seeks to gather support from the public. My disappointment in the President is only exceeded by my disappointment that no one in Congress stood tall and said – those statements are wrong! Do not think that these statements were overlooked by the medical profession; every physician I have talked with about the healthcare issue spontaneously brings up these two examples.
6. Absolute False Statements: One can intelligently debate issues without purposefully giving false statements to embellish one’s argument. The most glaring example was during President Obama’s speech before Congress on September 9, 2009 when he gave examples of abusive actions by insurers. Mr. Obama referred to a man in Illinois who “lost his coverage in the middle of chemotherapy because his insurer found he hadn’t reported gallstones that he didn’t even know about. They delayed treatment, and he died because of it.”
According to Scott Harrington of the Wall Street Journal: the President’s conclusion is contradicted by the transcript of a June 16 hearing of industry practices before the Subcommittee of Oversight and Investigation of the House Committee on Energy and Commerce. The deceased's sister testified that the insurer reinstated her brother's coverage following intervention by the Illinois Attorney General's Office. She testified that her brother received a prescribed stem-cell transplant within the desired three- to four-week "window of opportunity" from "one of the most renowned doctors in the whole world on the specific routine," that the procedure "was extremely successful," and that "it extended his life nearly three and a half years."
Representative Ann Kirkpatrick
September 23, 2009
Page Seven
Why would the President use a false statement on a nationally televised speech? Do we have to distort the facts to win our position? Why demonize the insurance industry in a fashion similar to the way he has demonized physicians? One can only conclude that the healthcare debate is really about President Obama delivering on a major social issue and not about what is best for the average American who is quite satisfied with their own personal health insurance situation. Once again Washington is about who wins and who loses – the people have been forgotten.
It is my sincere hope that you will vote against any of the current health care proposals before Congress (or any iteration of the same) and seek a more reasoned, incremental approach to addressing the major issues related to insurance ‘one problem at a time’. In the interim, this Congress and administration can immediately demonstrate its commitment to reform by implementing processes that actual identify and eliminate the ‘fraud and abuse’ in the current government medical programs.
Should you wish to discuss these issues in more depth, I would be happy to discuss them with you by phone, (928) 771-0978 or in person. Thank you for taking the time to read this lengthy letter.
Yours sincerely,
David S. Hess, M.D., F.A.C.C.
15 September 2009
Overview of Heath Care Issues
I try for due diligence in my research for serious essays, and then I try even harder to condense the essence of my conclusions into short essays. Recognizing that most folks expect blogs to be succinct, I limit my essays to a couple pages or so.
On the topic of health care in the U.S., the complexities and considerations of public versus private health care systems alone would require many books to address in detail. Consequently, the essays on current health care issues I have posted in this blog hardly scratch the surface, and even that surface treatment required three essays. I hope that readers of this blog will recognize that the three essays are intrinsically entwined.
You can review all three essays together by simply clicking on "Health Care Issues" below.
On the topic of health care in the U.S., the complexities and considerations of public versus private health care systems alone would require many books to address in detail. Consequently, the essays on current health care issues I have posted in this blog hardly scratch the surface, and even that surface treatment required three essays. I hope that readers of this blog will recognize that the three essays are intrinsically entwined.
You can review all three essays together by simply clicking on "Health Care Issues" below.
Reforming Our Great but Flawed Health Care System: Some Alternative Solutions to National Health Care
Obamacare supporters often charge that Republicans and other opponents only complain, without offering alternative solutions to address the problems with our current health care system. They claim that Republicans are opposed to any changes in the current system. This is absurd. Virtually everyone I know, Republicans, Democrats, and Independents alike, agree that our current system has problems that must be addressed; but, most also agree that the system should not be scrapped in favor of national health care. In fact, there are a half dozen or more proposed Republican health care bills that the Democrat leadership has so far refused to consider and the liberal media have ignored. Even President Obama has repeatedly said that his opposition has offered no alternatives. Although he maintains that his door remains open to any legislators who would like to offer alternatives, he has actually refused to meet with any Republican who has an alternative to offer. During his most recent televised address, the President completely ignored several Republicans who stood and waved their alternative proposals - partisan politics as usual.
So, in the hope that some Obamacare supporters are willing to transcend partisan politics, the following is a compilation of some of the alternatives that are commonly discussed in conservative circles, but receive scant attention by the liberal media and press. These proposals would go a long way toward solving the two greatest problems with our current health care system: decreasing the spiraling costs of healthcare, and providing healthcare insurance for those who cannot obtain or afford it.
• Transportability. Nearly everyone agrees that healthcare insurance should become transportable. Employees should be able to own their own insurance, and pay for it with pre-tax dollars just like the corporations now do. Employers could of course contribute toward the cost of this insurance just as many of them now do with employees’ 401Ks. Since individual employees, and not the corporations, would own the policies, the employees could take the insurance with them if they change jobs.
• Buying healthcare insurance across State lines. Again, nearly everyone agrees that individuals and corporations should be able to purchase health insurance from the most competitive bidder, regardless of State boundaries. Currently, most States prohibit the purchase of health insurance from any company that has not been pre-approved by the State. Such restrictions on purchasing health insurance should be eliminated. Purchase of health insurance should be open, just like automobile and property insurance. Some policies will be better or cheaper than others and the free market will sort them out.
• Pre-existing conditions. Again, nearly everyone agrees that people should not be refused health insurance coverage because of pre-existing conditions. There is no problem, of course with insurance companies offering a discount to healthy folks who don’t smoke, and do exercise and maintain proper weight, etc.
• Health Savings Accounts (HSAs) - this one is apparently controversial, because it is currently available and quite popular, yet all of the current legislation proposed by Democrats eliminates it. An HSA allows individuals and families to purchase catastrophic health insurance coverage, i.e., a very high deductible, while assuming responsibility for all health care expenses below the deductible. Except for small co-pays, health care expenses above the deductible are paid for by the insurer. The purchaser must then contribute funds into a Health Savings Account using pre-tax dollars. Once the purchaser has deposited an amount equal to the deductible, contributions can of course stop. The money in the HSA can be withdrawn, with no tax penalty, for certain expenses such as education, purchase of a home, or health care. When any amount is withdrawn, contributions must of course resume until the deductible is met.
• National Catastrophic Health Care Insurance (NCI). Again, the insurance would only cover catastrophic costs above a certain limit, and the purchaser would be responsible for routine costs below the limit. The coverage would be standardized and the implementation would be similar to the existing national flood insurance.
• Routine health care. The primary feature of both HSAs and NCI is that routine health care is paid for by the individuals, as opposed to the insurer. This feature has the great benefit of decreasing the overall amount spent on health care for the following reason. People who have only a small health insurance co-pay and/or deductible tend to go to the Doctor or the ER for minor problems; and, they have no incentive to object to, or even inquire about the need for, expensive tests and procedures. When such visits, tests, and procedures are paid for by the individuals themselves, as opposed to insurance, they visit the doctor less, and question the necessity of tests and procedures.
• No medical bankruptcy. Because both plans pay for virtually all healthcare above the deductible/limit, HSAs and NCI would both preclude any participant from ever being bankrupted by medical bills.
• Advantages of HSA. The advantages of HSAs over NCI are that the HSA savings are required and are made with pre-tax dollars. Additionally, once an amount equal to the deductible has been deposited, no further contributions are required. With the National plan, individuals would have to either pay the initial health care costs out of pocket, with after tax dollars, or use the ER.
• Tort reform. This is a complex process that must simultaneously protect the rights of individuals who have been harmed, while precluding spurious lawsuits. A reform that is often mentioned is that the fee collected by the suing attorneys should be limited. These attorneys should of course be reimbursed for all of their out of pocket expenses, but their fees should be capped, say at $1,000,000. Another reform might be to contribute any punitive damages above $1,000,000 toward providing indigent health care insurance, for example, rather than enriching tort attorneys. There are many other tort reforms to be considered, but the end result must protect the individual right to sue while ending spurious law suits.
• Living wills. For most of us, a huge proportion of our lifetime medical expenses will be encumbered during the last year of our lives. Other cultures allow you to die peacefully at home, in no pain or discomfort (drugged to the hilt if necessary), as opposed to undergoing terribly expensive, horribly intrusive, demeaning, and often painful, medical procedures. However heroic such medical intervention may be, I'll take the peaceful death at home, thank you. The primary culprits here are loved ones who cannot bear the thought of parting with the patient (particularly if the patient is young), urged on by medical personnel trained to save the patient at any cost. We need a nationwide campaign in the media, churches, synagogues, community centers, hospitals, rehabilitation centers, and nursing homes, etc. to convince everyone, especially those with terminal illnesses or conditions, to prepare a living will. A living will specifies the patient’s choices regarding various medical procedures, and thus spares loved ones the trauma of making those difficult decisions for them. Please note that I am not suggesting we require anyone to refuse care, and I am certainly not suggesting that any provider be required to deny care or procedures - only that the dying person should retain the option to refuse care and die with dignity.
• Local clinics. Emergency Rooms should be supplemented by local urgent care clinics, whose function it would be to provide routine care such as treating cuts, sprains, colds, flu, minor infections, etc. – more serious problems would be referred to ERs. Such clinics could be headed by Nurse Practitioners and/or Physician Assistants without the involvement or supervision of MDs or DOs (Federal and State regulations would have to be changed to allow this), and the required medical equipment would be minimal. Whether paid for by individuals, insurers, or public funds in the case of the indigent, the routine care provided by such clinics would cost a fraction of ER care. The clinics would also reduce ER overcrowding and allow ERs to treat emergencies as opposed to routine health problems.
All of these are ideas that could be enacted or encouraged by the federal government. All of them would greatly improve, yet be consistent with, the current system. No one would have to give up any benefits they already have. Most importantly, none of them require a national health care system.
Perhaps we will someday conclude that a national health care system is in our best interests. But let’s not be impulsive about reaching that conclusion. Let’s be prudent and proceed deliberately. Let’s debate the issues at length and hold a long and detailed national discussion. Let’s try to fix the problems before we consider scrapping the entire system. Let’s take some baby steps before we jump off the cliff. We do not have to do this immediately. This has been an ongoing problem for at least 25 years – it is not a crisis. We should address the issues rationally and sensibly. We must resist the attempt by the President and congress to rush through the biggest and most expensive legislation in our history without giving the nation a chance to consider options and understand the wide-ranging implications. Let’s take a deep breath, and really think about it.
So, in the hope that some Obamacare supporters are willing to transcend partisan politics, the following is a compilation of some of the alternatives that are commonly discussed in conservative circles, but receive scant attention by the liberal media and press. These proposals would go a long way toward solving the two greatest problems with our current health care system: decreasing the spiraling costs of healthcare, and providing healthcare insurance for those who cannot obtain or afford it.
• Transportability. Nearly everyone agrees that healthcare insurance should become transportable. Employees should be able to own their own insurance, and pay for it with pre-tax dollars just like the corporations now do. Employers could of course contribute toward the cost of this insurance just as many of them now do with employees’ 401Ks. Since individual employees, and not the corporations, would own the policies, the employees could take the insurance with them if they change jobs.
• Buying healthcare insurance across State lines. Again, nearly everyone agrees that individuals and corporations should be able to purchase health insurance from the most competitive bidder, regardless of State boundaries. Currently, most States prohibit the purchase of health insurance from any company that has not been pre-approved by the State. Such restrictions on purchasing health insurance should be eliminated. Purchase of health insurance should be open, just like automobile and property insurance. Some policies will be better or cheaper than others and the free market will sort them out.
• Pre-existing conditions. Again, nearly everyone agrees that people should not be refused health insurance coverage because of pre-existing conditions. There is no problem, of course with insurance companies offering a discount to healthy folks who don’t smoke, and do exercise and maintain proper weight, etc.
• Health Savings Accounts (HSAs) - this one is apparently controversial, because it is currently available and quite popular, yet all of the current legislation proposed by Democrats eliminates it. An HSA allows individuals and families to purchase catastrophic health insurance coverage, i.e., a very high deductible, while assuming responsibility for all health care expenses below the deductible. Except for small co-pays, health care expenses above the deductible are paid for by the insurer. The purchaser must then contribute funds into a Health Savings Account using pre-tax dollars. Once the purchaser has deposited an amount equal to the deductible, contributions can of course stop. The money in the HSA can be withdrawn, with no tax penalty, for certain expenses such as education, purchase of a home, or health care. When any amount is withdrawn, contributions must of course resume until the deductible is met.
• National Catastrophic Health Care Insurance (NCI). Again, the insurance would only cover catastrophic costs above a certain limit, and the purchaser would be responsible for routine costs below the limit. The coverage would be standardized and the implementation would be similar to the existing national flood insurance.
• Routine health care. The primary feature of both HSAs and NCI is that routine health care is paid for by the individuals, as opposed to the insurer. This feature has the great benefit of decreasing the overall amount spent on health care for the following reason. People who have only a small health insurance co-pay and/or deductible tend to go to the Doctor or the ER for minor problems; and, they have no incentive to object to, or even inquire about the need for, expensive tests and procedures. When such visits, tests, and procedures are paid for by the individuals themselves, as opposed to insurance, they visit the doctor less, and question the necessity of tests and procedures.
• No medical bankruptcy. Because both plans pay for virtually all healthcare above the deductible/limit, HSAs and NCI would both preclude any participant from ever being bankrupted by medical bills.
• Advantages of HSA. The advantages of HSAs over NCI are that the HSA savings are required and are made with pre-tax dollars. Additionally, once an amount equal to the deductible has been deposited, no further contributions are required. With the National plan, individuals would have to either pay the initial health care costs out of pocket, with after tax dollars, or use the ER.
• Tort reform. This is a complex process that must simultaneously protect the rights of individuals who have been harmed, while precluding spurious lawsuits. A reform that is often mentioned is that the fee collected by the suing attorneys should be limited. These attorneys should of course be reimbursed for all of their out of pocket expenses, but their fees should be capped, say at $1,000,000. Another reform might be to contribute any punitive damages above $1,000,000 toward providing indigent health care insurance, for example, rather than enriching tort attorneys. There are many other tort reforms to be considered, but the end result must protect the individual right to sue while ending spurious law suits.
• Living wills. For most of us, a huge proportion of our lifetime medical expenses will be encumbered during the last year of our lives. Other cultures allow you to die peacefully at home, in no pain or discomfort (drugged to the hilt if necessary), as opposed to undergoing terribly expensive, horribly intrusive, demeaning, and often painful, medical procedures. However heroic such medical intervention may be, I'll take the peaceful death at home, thank you. The primary culprits here are loved ones who cannot bear the thought of parting with the patient (particularly if the patient is young), urged on by medical personnel trained to save the patient at any cost. We need a nationwide campaign in the media, churches, synagogues, community centers, hospitals, rehabilitation centers, and nursing homes, etc. to convince everyone, especially those with terminal illnesses or conditions, to prepare a living will. A living will specifies the patient’s choices regarding various medical procedures, and thus spares loved ones the trauma of making those difficult decisions for them. Please note that I am not suggesting we require anyone to refuse care, and I am certainly not suggesting that any provider be required to deny care or procedures - only that the dying person should retain the option to refuse care and die with dignity.
• Local clinics. Emergency Rooms should be supplemented by local urgent care clinics, whose function it would be to provide routine care such as treating cuts, sprains, colds, flu, minor infections, etc. – more serious problems would be referred to ERs. Such clinics could be headed by Nurse Practitioners and/or Physician Assistants without the involvement or supervision of MDs or DOs (Federal and State regulations would have to be changed to allow this), and the required medical equipment would be minimal. Whether paid for by individuals, insurers, or public funds in the case of the indigent, the routine care provided by such clinics would cost a fraction of ER care. The clinics would also reduce ER overcrowding and allow ERs to treat emergencies as opposed to routine health problems.
All of these are ideas that could be enacted or encouraged by the federal government. All of them would greatly improve, yet be consistent with, the current system. No one would have to give up any benefits they already have. Most importantly, none of them require a national health care system.
Perhaps we will someday conclude that a national health care system is in our best interests. But let’s not be impulsive about reaching that conclusion. Let’s be prudent and proceed deliberately. Let’s debate the issues at length and hold a long and detailed national discussion. Let’s try to fix the problems before we consider scrapping the entire system. Let’s take some baby steps before we jump off the cliff. We do not have to do this immediately. This has been an ongoing problem for at least 25 years – it is not a crisis. We should address the issues rationally and sensibly. We must resist the attempt by the President and congress to rush through the biggest and most expensive legislation in our history without giving the nation a chance to consider options and understand the wide-ranging implications. Let’s take a deep breath, and really think about it.
14 September 2009
Why is national health care so popular in other countries?
President Obama’s supporters often complain that opponents of national health care are opposed to any reform. Baloney. We who oppose the currently proposed health care bills are not opposed to reforming our health care system. We know it has problems and we want to fix those problems, but we also know that, although our heath care system is not perfect, it also is not completely broken. For more than 75% of us, the system works well, so we are opposed to a complete transformation from a private to a public system. We want change, not revolution.
So, at this point, it seems the debate boils down to whether we prefer a public or private health care system. One of the major arguments in favor of a national system is that virtually all western countries have some form of national health care. The major benefits seem to be that everyone is covered and it is less expensive. These notions are very interesting. They suggest that government can provide more service at a lower cost than private enterprise and the free market. This seems counter-intuitive to most of us and flies in the face of our very successful capitalist economic system, not to mention that most Americans consider government programs to be bureaucratic, hide-bound, inefficient, and financially profligate. Nonetheless, all those other countries that seem to like their national health care cannot be ignored. Why do they like their national health care so much?
The answer is actually fairly straight-forward. It is a classical demonstration of the difficulty of applying statistics to human endeavor. We begin by noting that western societies generally provide living conditions that are quite safe and healthy. Consequently, prior to attaining the “end of life” years, most of us encounter relatively few serious medical problems. We rarely seek medical help, and then usually for fairly simple problems that any reasonably competent provider can adequately address – cuts and sprains, colds and flu, acid stomachs, high blood pressure, and such. For most of us, these routine types of medical issues will be all we ever encounter until we are old. Since any health care system can adequately deal with such routine issues, national health care is as good as any other. Simply stated, 90% or more of young and middle aged westerners only require routine medical care, so those 90% are perfectly satisfied with national health care. Additionally, routine heath care usually does not require expensive tests, procedures, or specialists, so the cost is relatively low. So, since any system can deal with routine medical issues, and such issues are relatively inexpensive to treat, national health care systems can treat them effectively and at a reasonable cost. In summary, national health care systems do fine 90% or more of the time. By any statistical measure, they work well.
But this is not a study in statistics. Medical issues are personal. Although national health care may be fine 90% of the time, the care received by the other 10% is an equally important measure of the quality of the health care system. Quality care means treating individual people, not the average person or even the 90% majority. When you become seriously injured or ill, when you have a serious medical condition that requires expensive tests, specialists, complex operations, intensive care, and long term recovery, you could care less what the polling data say or what most folks think of the system. You need comprehensive quality care, now!
In countries that have national health care, people who seek care for serious medical conditions often complain about the competency of their specialists and surgeons, and about the long waits necessary to get approval for expensive tests or specialists or surgery. Additionally, once approval is granted, they encounter more long waits to actually obtain the tests, see the specialists, or have the surgery. These are people with serious medical conditions – the kind that require timely care before they deteriorate too far. Yet these are the very people that are forced to wait. These are the other 10%. These are the people who need health care the most and receive it the least. That’s why those that can afford it come to the U.S. for treatment of serious conditions.
Try this analogy. Assume the tap water in 90% of the neighborhoods in a town is clean and healthy, but the water in the other 10% of the neighborhoods is dangerous and can cause serious bodily harm if consumed. If you poll the residents of the town, 90% will say their water is fine, but who would argue that this town has a water crisis that must be addressed? Even though 90% of the residents are perfectly happy with their water, the town’s water system is terribly flawed and unsatisfactory.
That’s exactly the situation with national health care. For 90% of the people, it is fine, but, because of the serious problems encountered by the other 10%, the overall system is flawed and unsatisfactory. Polls are statistics that measure quantity, not quality. That’s why polls show that residents are overwhelmingly satisfied with national health care systems.
Here at home, most of us agree that two of the major problems with the U.S. health care system are the escalating costs and the 5% or so of our citizens that cannot obtain or afford health insurance. While a national health care system might well address both of these problems, it would doubtlessly decrease the quality of health care in America.
The problem with national health care is that, like most large bureaucracies, it handles routine reasonably well, but it wilts in the face of the unusual or abnormal. National health care systems provide an adequate quantity of heath care, but poor quality to those in greatest need. Private health care in the U.S. provides excellent but expensive quality, but inadequate quantity. Our goal must be to provide excellent quality and quantity at a reasonable price. This is indeed an ambitious goal, and one that can never be achieved by a government run program.
So, at this point, it seems the debate boils down to whether we prefer a public or private health care system. One of the major arguments in favor of a national system is that virtually all western countries have some form of national health care. The major benefits seem to be that everyone is covered and it is less expensive. These notions are very interesting. They suggest that government can provide more service at a lower cost than private enterprise and the free market. This seems counter-intuitive to most of us and flies in the face of our very successful capitalist economic system, not to mention that most Americans consider government programs to be bureaucratic, hide-bound, inefficient, and financially profligate. Nonetheless, all those other countries that seem to like their national health care cannot be ignored. Why do they like their national health care so much?
The answer is actually fairly straight-forward. It is a classical demonstration of the difficulty of applying statistics to human endeavor. We begin by noting that western societies generally provide living conditions that are quite safe and healthy. Consequently, prior to attaining the “end of life” years, most of us encounter relatively few serious medical problems. We rarely seek medical help, and then usually for fairly simple problems that any reasonably competent provider can adequately address – cuts and sprains, colds and flu, acid stomachs, high blood pressure, and such. For most of us, these routine types of medical issues will be all we ever encounter until we are old. Since any health care system can adequately deal with such routine issues, national health care is as good as any other. Simply stated, 90% or more of young and middle aged westerners only require routine medical care, so those 90% are perfectly satisfied with national health care. Additionally, routine heath care usually does not require expensive tests, procedures, or specialists, so the cost is relatively low. So, since any system can deal with routine medical issues, and such issues are relatively inexpensive to treat, national health care systems can treat them effectively and at a reasonable cost. In summary, national health care systems do fine 90% or more of the time. By any statistical measure, they work well.
But this is not a study in statistics. Medical issues are personal. Although national health care may be fine 90% of the time, the care received by the other 10% is an equally important measure of the quality of the health care system. Quality care means treating individual people, not the average person or even the 90% majority. When you become seriously injured or ill, when you have a serious medical condition that requires expensive tests, specialists, complex operations, intensive care, and long term recovery, you could care less what the polling data say or what most folks think of the system. You need comprehensive quality care, now!
In countries that have national health care, people who seek care for serious medical conditions often complain about the competency of their specialists and surgeons, and about the long waits necessary to get approval for expensive tests or specialists or surgery. Additionally, once approval is granted, they encounter more long waits to actually obtain the tests, see the specialists, or have the surgery. These are people with serious medical conditions – the kind that require timely care before they deteriorate too far. Yet these are the very people that are forced to wait. These are the other 10%. These are the people who need health care the most and receive it the least. That’s why those that can afford it come to the U.S. for treatment of serious conditions.
Try this analogy. Assume the tap water in 90% of the neighborhoods in a town is clean and healthy, but the water in the other 10% of the neighborhoods is dangerous and can cause serious bodily harm if consumed. If you poll the residents of the town, 90% will say their water is fine, but who would argue that this town has a water crisis that must be addressed? Even though 90% of the residents are perfectly happy with their water, the town’s water system is terribly flawed and unsatisfactory.
That’s exactly the situation with national health care. For 90% of the people, it is fine, but, because of the serious problems encountered by the other 10%, the overall system is flawed and unsatisfactory. Polls are statistics that measure quantity, not quality. That’s why polls show that residents are overwhelmingly satisfied with national health care systems.
Here at home, most of us agree that two of the major problems with the U.S. health care system are the escalating costs and the 5% or so of our citizens that cannot obtain or afford health insurance. While a national health care system might well address both of these problems, it would doubtlessly decrease the quality of health care in America.
The problem with national health care is that, like most large bureaucracies, it handles routine reasonably well, but it wilts in the face of the unusual or abnormal. National health care systems provide an adequate quantity of heath care, but poor quality to those in greatest need. Private health care in the U.S. provides excellent but expensive quality, but inadequate quantity. Our goal must be to provide excellent quality and quantity at a reasonable price. This is indeed an ambitious goal, and one that can never be achieved by a government run program.
08 September 2009
The So Called Heath Care Crisis
The President of the United States United States
In fact, we have the best health care in the world, witness all the muckety-mucks from all over the world coming here for critical care. How many of our muckety-mucks go abroad for health care? Some of us do go abroad for medical procedures or drugs, but only to save money. Americans do not seriously believe they will receive better heath care abroad, just cheaper heath care. Ask yourself, if you get some horrible disease or suffer some terrible injury, would you rather be treated at Mass General, the Mayo Clinic, or any of dozens of other great medical centers here in the U.S., or, would you rather be treated in Spain, or Sweden, or India, or Mexico, or anywhere else? For fabulous health care, this is the place – the good old U.S.A.
So, we do not have a heath care crisis. In fact, we have the best health care in the world, but our health care system is not perfect. There are problems (not crises), and the major ones are two-fold: our health care costs too much, and some of us are either uninsured or underinsured (that’s the 45 million you hear about so often).
The Obama administration and the Democratic leadership are pushing with all their might to address these issues by throwing out our present, mostly private, heath care coverage system and replacing it with a public national heath care system. Seriously? About 75% of us are perfectly satisfied with our present insurance coverage. Our only complaint is that the costs keep rising. Hey Washington, here’s a piece of advice from an engineer and businessman. Fit the solution to the problem. Do not impose a 100% solution to fix a 25% problem. When a system is working fine 75% of the time, do not attempt to fix the 25% problem by throwing out the entire system and starting over. Bulletin: your new system will inevitably cost too much and it will have problems of its own! For example, if your house has a plumbing problem, do not tear it down and build a new house. Fix the plumbing. If you build a new house, it will cost more that you thought and it will have problems of its own. In the case of health care in the U.S.
What about the 45 million that we keep hearing about who do not have coverage? As most folks have already heard, recent studies have shown that more than 10 million of these are illegal aliens, millions more are healthy young people who freely choose not to pay for coverage, millions more are workers who are between jobs and choose not to pay for the COBRA coverage that is available to them, etc., etc.. In the end, there are about 10 – 15 million actual Americans who cannot get or afford heath insurance. There can be no doubt we must do something about these unfortunate folks. We must care for the least of us. So, let’s see. 15 million is about 5% of our population. Obama wants to throw out the entire system to fix a 5% problem? Here’s another bulletin: just provide national coverage for the 5%! Don’t impose a national health care system on the rest of us! If you want to raise my taxes to pay for the 5%, go for it. I should and I will pay. But do not endanger my excellent health care and my excellent heath care coverage and force me and my grandchildren to pay for a national health care system that we do not need, we do not want, and we cannot afford! If the bathwater is dirty, change the water; do not throw out the tub and the baby!
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