Her argument -- such as it is -- that Obama's plan is "evil" and that it's going to force elderly people and retarded children to go before "death panels" -- makes sense only in the most paranoid minds. No one who is proposing a health care plan on behalf of the government -- Congress or the White House -- has a "death panel" component to their plan. To twist any existing component in any plan into a "death panel" takes a warped and paranoid mind.
Of course no one has put anything named a "death panel" in any bill. But if you think that she's inaccurate, then you haven't been paying attention, either to the things Obama's been saying, or to the sort of things that go on in other countries such as Canada and the UK, or even on Indian Reservations right here in the US (don't get sick after June!).
There has been much talk of deciding which treatments are the most cost effective, and how to allocate scarce resources. Look at what's been going on in Oregon, for instance.
I think it's the people suggesting we allow the government to do this sort of thing who have the warped minds.
In particular, a Cornell Law professor basically supports Palin's claims. Note that he uses quotes from BHO himself, and "key Obama health care adviser Dr. Ezekial Emanuel (brother of Chief of Staff Rahm Emanuel)."
All: I'm not supporting ObamaCare...in fact, he's doing such a poor job of articulating its major points I'm not even sure what it IS.
After all the boo-hooing about the victimization of Sarah Palin, I just thought it was interesting that without provocation, she jumped into the spotlight with a very controversial, extreme statement, and used her child and parents as cover. I thought it was pretty shameful and pathetic, that's all.
I sincerely hope that for the good of all concerned, the Republican Party can come up with a decent candidate for President in the next few years...because let's be honest, they haven't had a strong candidate since 1992. And I call George H.W. Bush "strong" in the sense that he was eminently qualified, ignoring his constant inability to speak in complete sentences..."That vision thing", and such.
I'm not sure that "without provocation" makes much sense here. When she resigned, one of the reasons she gave was that she thought she could be more effective politically as a private citizen. So far, that seems to be accurate.
Her use of her parents and son don't strike me as 'cover' as much as they are examples of the sorts of people who have to worry about whether they'll be treated. Combine other anecdotes and statistics from places like the UK and Canada with comments Obama has made, and it seems pretty obvious to me what she's worried about--it's one issue that has disturbed me before she said anything on the topic.
Matt, your last comment to me is part of what's wrong with this whole debate -- string together pieces of disparate and in some cases dubious origin or connection -- and throw in a dash of conspiratorial salt? Really?
One can string together enough anecdotes, "statistics" -- the easy manipulation and misinterpretation of which you have previously railed against -- and pieces of speeches to make any argument -- but that doesn't make it a sound analysis.
I don't believe for one minute that it would be politically tenable for Congress (which, after all, has to write and vote on the bill(s) before it can be signed by a President) to put forward legislation that contains any draconian restrictions on care for vulnerable classes of people such as disabled chilren or the elderly. We hardly live in a Soylent Green society. In fact, it would be more accurate to say we live in an AARP Society -- and one of the world's most powerful lobbying groups would hardly stand for its members being shortchanged.
It's funny, too, that opponents of health care reform are wielding the scare stick of "He'll take your health care away!", but have kept quiet for decades about the heavy-handed management, regulation, and denial of care and compensation to patients and service providers by the same private insurance companies conservatives now tout as the continued solution to our health care problems.
You want anecdotes to support that? Think back to your days at UCOW, denying patients access to care who didn't have their referrals from Capital Care -- "I'm sorry, ma'am, you can't see the doctor for your glaucoma, you don't have a referral" (yea, HMOs!), or collecting $$ on unpaid claims. Hell, I collected $400K+ in 4 months just calling back insurance companies who had in many cases found convenient reasons to delay or deny payment for services rendered, only to pay up when pressed just a bit.
And, in 2000, when my maternal grandmother suffered a stroke, my family found care for her at a rehabilitative institute known as Brittany Farms. Initially, she could not speak or walk. But, with aggressive care, she made immediate, then sustained progress.
Yet, that wasn't good enough for her insurance company, who sent letter after letter to our family and to Brittany Farms, demanding her removal to a less expensive (and less functional) convalescent home, because they saw "no evidence" of progress. We documented in excruciating detail her progress from near-vegetable to nearly full-functioning human being, and supported our evidence with letters drafted and signed by her doctors, to get the insurance company to back off.
Even then, we were only moderately successful, with the insurance company limiting her stay to a shorter period than was recommended by the medical professionals tending to her rehabilitation.
All of this is to say that the private market that guides and executes the provision of health care is hardly perfect, and could stand some reform -- and it probably won't occur without some government intervention -- because as we've seen with the financial markets (the established unhelpful meddling of Congress and the incompetence of quasi-governmental institutions Freddie Mac and Fannie May notwithstanding), some human beings in a lightly and loosely regulated market will abuse that market to squeeze out every last dollar in profit, consequences (and the health of their customers) be damned. Just ask the global financial markets how well that's been working for them the last 2 years or so.
Sadly, we probably won't get meaningful reform. Between the president's inability to articulate what exactly he wants in the way of reform, except, "Costs too high! Insurance companies bad!", and the gutless, shameful, dishonest fear-mongering that Limbaugh (like Hitler, Obama also rules by dictate? Really? Fuckwad), Beck, Hannity, Gingrich, Bachman, Palin, and others have engaged in, we have likely lost any opportunity for providing better, lower-cost care for all.
PS the Oregon article you referenced hardly describes radical behavior. Insurance companies as a matter of daily routine publish (and enforce) guides to procedures, activities, and drugs for which they will or will not compensate patients and providers.
And, medical institutions publish guides to procedures and activities they will and will not perform. How is Oregon's activity any different (or any worse) than what other players in the medical industry do every day?
There is a huge difference between voluntary contracts between private parties and the enforcement of government policy. It's true that choices are often very limited, but this is largely due to (once again) government interference in the market.
There are a few government interventions that are definitely needed. First, tort reform. Next, Congress needs to make 2 key changes: equalize the tax treatment for buying private insurance, and allow the purchase of insurance across state lines.
One of the biggest problems with health care is that it's largely free at the point of service. Since health care consumers aren't aware of the costs involved (hell, most of us barely even pay attention to the premiums we pay, and probably have no clue about what our employers pay) the only party interested in constraining costs are the insurance companies. Under that system, there's unfortunately no way around the inevitable conflict between the consumer and the insurance company.
Too much of this debate assumes that it's logical and correct to pay 1950s prices for 21st century care. Unfortunately, we're not focusing on the obvious things that could make a real difference.
I think your grandmother makes an excellent example of the sort of person who is better off under the current system. If the government were in charge the way some of the proposals have been put forth, her QALYs would likely be too low for much treatment at all. It's inevitable, really, when you have a system with an arbitrary budget ceiling, and demand that must be constrained by fiat.
I think it's reasonable to assume that the goal of whomever is in charge of setting prices, etc, assuming the government takes over health care, is to spend the dollars to get the most bang for each buck. So, on average, our health may be the best it can be under that system. However, that doesn't mean it wouldn't be better under another system. And the losers will be those upon whom a disproportionate number of dollars are spent for relatively little gain. Why do a hip replacement on an 80 year old, when there are 40 year olds with breast cancer? Something has to give.
I haven't heard enough Rush lately to know exactly what he was saying about Obama "ruling by dictate," but if I had to guess, I'd say he's referring to how Obama seems to think the government should work. And that includes him ordering around the Congress. Consider that his M.O. is basically to talk about general principles, leaving the details to others. To him, details aren't even interesting. They just get in the way. But his goals are so great, and he's such a great communicator that we should all just go along. He doesn't even try to make rational arguments. We all should just take him at his word. Transparency, indeed.
I would certainly agree that the current reform effort has laid bare a considerable failing on the part of the President -- as you say, details appear to be a bother for others to sort out. It appears he'd rather hold more love-in rallies where everyone tells him how great he is than roll up his sleeves and get dirty diving into the nasty business of actual governing. He'd better get a clue fast, or he'll go from "first-to-worst" and find himself out on his rear end after one term.
As for the rest of your comments, I'm too tired to think about them. My son spiked a 104 degree fever last night, spent part of the night at the ER, and oh, when we showed up at his pediatrician's at 7:45 this morning for a follow-up, found out that we had a balance of over $1,000 because Blue Cross/Blue Shield had denied 4 claims from June and July for the utterly baseless reason that we had some mystical "other insurance" that needed to be billed before they would consider payment.
When we called BC/BS just now, they admitted that their position had no merit, and agreed to resubmit the claims for payment.
But in the meantime, they managed to stall payment of over $1,000 to our family physician, cause the physician to warn us that failure to address the issue immediately would cause a stoppage in care, and caused us (only, thankfully) temporary embarrassment -- because I've known the head RN at this office since I was a small boy, and her husband and my dad are best friends.
Thanks, efficient private health insurance company!
Hope he feels better. We had random vomiting one night last week. He took several showers after 10PM.
Just imagine how quickly your doctor will be paid when the payor doesn't have to worry about you changing insurance. The friendliness of the IRS combined with the efficiency of the Post Office.
Actually, one worrisome thing is the IRS snooping in health care expenditures in order to ensure compliance with the tax for mandating insurance.
He gives some good background on why these concerns are real. Unfortunately, according to the President, quoting things that he and his advisers said in the past amounts to spreading misconceptions. Which, frankly, is how most of the things he says come across to me.
13 comments:
Her argument makes sense to me. Unlike your unhealthy obsession.
Her argument -- such as it is -- that Obama's plan is "evil" and that it's going to force elderly people and retarded children to go before "death panels" -- makes sense only in the most paranoid minds. No one who is proposing a health care plan on behalf of the government -- Congress or the White House -- has a "death panel" component to their plan. To twist any existing component in any plan into a "death panel" takes a warped and paranoid mind.
Of course no one has put anything named a "death panel" in any bill. But if you think that she's inaccurate, then you haven't been paying attention, either to the things Obama's been saying, or to the sort of things that go on in other countries such as Canada and the UK, or even on Indian Reservations right here in the US (don't get sick after June!).
There has been much talk of deciding which treatments are the most cost effective, and how to allocate scarce resources. Look at what's been going on in Oregon, for instance.
I think it's the people suggesting we allow the government to do this sort of thing who have the warped minds.
In particular, a Cornell Law professor basically supports Palin's claims. Note that he uses quotes from BHO himself, and "key Obama health care adviser Dr. Ezekial Emanuel (brother of Chief of Staff Rahm Emanuel)."
Brian, I refer you to Commandment #9 "Thou shalt not engineer society."
http://commandmentsoflife.blogspot.com/
All: I'm not supporting ObamaCare...in fact, he's doing such a poor job of articulating its major points I'm not even sure what it IS.
After all the boo-hooing about the victimization of Sarah Palin, I just thought it was interesting that without provocation, she jumped into the spotlight with a very controversial, extreme statement, and used her child and parents as cover. I thought it was pretty shameful and pathetic, that's all.
I sincerely hope that for the good of all concerned, the Republican Party can come up with a decent candidate for President in the next few years...because let's be honest, they haven't had a strong candidate since 1992. And I call George H.W. Bush "strong" in the sense that he was eminently qualified, ignoring his constant inability to speak in complete sentences..."That vision thing", and such.
I'm not sure that "without provocation" makes much sense here. When she resigned, one of the reasons she gave was that she thought she could be more effective politically as a private citizen. So far, that seems to be accurate.
Her use of her parents and son don't strike me as 'cover' as much as they are examples of the sorts of people who have to worry about whether they'll be treated. Combine other anecdotes and statistics from places like the UK and Canada with comments Obama has made, and it seems pretty obvious to me what she's worried about--it's one issue that has disturbed me before she said anything on the topic.
Matt, your last comment to me is part of what's wrong with this whole debate -- string together pieces of disparate and in some cases dubious origin or connection -- and throw in a dash of conspiratorial salt? Really?
One can string together enough anecdotes, "statistics" -- the easy manipulation and misinterpretation of which you have previously railed against -- and pieces of speeches to make any argument -- but that doesn't make it a sound analysis.
I don't believe for one minute that it would be politically tenable for Congress (which, after all, has to write and vote on the bill(s) before it can be signed by a President) to put forward legislation that contains any draconian restrictions on care for vulnerable classes of people such as disabled chilren or the elderly. We hardly live in a Soylent Green society. In fact, it would be more accurate to say we live in an AARP Society -- and one of the world's most powerful lobbying groups would hardly stand for its members being shortchanged.
It's funny, too, that opponents of health care reform are wielding the scare stick of "He'll take your health care away!", but have kept quiet for decades about the heavy-handed management, regulation, and denial of care and compensation to patients and service providers by the same private insurance companies conservatives now tout as the continued solution to our health care problems.
You want anecdotes to support that? Think back to your days at UCOW, denying patients access to care who didn't have their referrals from Capital Care -- "I'm sorry, ma'am, you can't see the doctor for your glaucoma, you don't have a referral" (yea, HMOs!), or collecting $$ on unpaid claims. Hell, I collected $400K+ in 4 months just calling back insurance companies who had in many cases found convenient reasons to delay or deny payment for services rendered, only to pay up when pressed just a bit.
And, in 2000, when my maternal grandmother suffered a stroke, my family found care for her at a rehabilitative institute known as Brittany Farms. Initially, she could not speak or walk. But, with aggressive care, she made immediate, then sustained progress.
Yet, that wasn't good enough for her insurance company, who sent letter after letter to our family and to Brittany Farms, demanding her removal to a less expensive (and less functional) convalescent home, because they saw "no evidence" of progress. We documented in excruciating detail her progress from near-vegetable to nearly full-functioning human being, and supported our evidence with letters drafted and signed by her doctors, to get the insurance company to back off.
Even then, we were only moderately successful, with the insurance company limiting her stay to a shorter period than was recommended by the medical professionals tending to her rehabilitation.
All of this is to say that the private market that guides and executes the provision of health care is hardly perfect, and could stand some reform -- and it probably won't occur without some government intervention -- because as we've seen with the financial markets (the established unhelpful meddling of Congress and the incompetence of quasi-governmental institutions Freddie Mac and Fannie May notwithstanding), some human beings in a lightly and loosely regulated market will abuse that market to squeeze out every last dollar in profit, consequences (and the health of their customers) be damned. Just ask the global financial markets how well that's been working for them the last 2 years or so.
Sadly, we probably won't get meaningful reform. Between the president's inability to articulate what exactly he wants in the way of reform, except, "Costs too high! Insurance companies bad!", and the gutless, shameful, dishonest fear-mongering that Limbaugh (like Hitler, Obama also rules by dictate? Really? Fuckwad), Beck, Hannity, Gingrich, Bachman, Palin, and others have engaged in, we have likely lost any opportunity for providing better, lower-cost care for all.
Sad.
PS the Oregon article you referenced hardly describes radical behavior. Insurance companies as a matter of daily routine publish (and enforce) guides to procedures, activities, and drugs for which they will or will not compensate patients and providers.
And, medical institutions publish guides to procedures and activities they will and will not perform. How is Oregon's activity any different (or any worse) than what other players in the medical industry do every day?
There is a huge difference between voluntary contracts between private parties and the enforcement of government policy. It's true that choices are often very limited, but this is largely due to (once again) government interference in the market.
There are a few government interventions that are definitely needed. First, tort reform. Next, Congress needs to make 2 key changes: equalize the tax treatment for buying private insurance, and allow the purchase of insurance across state lines.
One of the biggest problems with health care is that it's largely free at the point of service. Since health care consumers aren't aware of the costs involved (hell, most of us barely even pay attention to the premiums we pay, and probably have no clue about what our employers pay) the only party interested in constraining costs are the insurance companies. Under that system, there's unfortunately no way around the inevitable conflict between the consumer and the insurance company.
Too much of this debate assumes that it's logical and correct to pay 1950s prices for 21st century care. Unfortunately, we're not focusing on the obvious things that could make a real difference.
I think your grandmother makes an excellent example of the sort of person who is better off under the current system. If the government were in charge the way some of the proposals have been put forth, her QALYs would likely be too low for much treatment at all. It's inevitable, really, when you have a system with an arbitrary budget ceiling, and demand that must be constrained by fiat.
I think it's reasonable to assume that the goal of whomever is in charge of setting prices, etc, assuming the government takes over health care, is to spend the dollars to get the most bang for each buck. So, on average, our health may be the best it can be under that system. However, that doesn't mean it wouldn't be better under another system. And the losers will be those upon whom a disproportionate number of dollars are spent for relatively little gain. Why do a hip replacement on an 80 year old, when there are 40 year olds with breast cancer? Something has to give.
I haven't heard enough Rush lately to know exactly what he was saying about Obama "ruling by dictate," but if I had to guess, I'd say he's referring to how Obama seems to think the government should work. And that includes him ordering around the Congress. Consider that his M.O. is basically to talk about general principles, leaving the details to others. To him, details aren't even interesting. They just get in the way. But his goals are so great, and he's such a great communicator that we should all just go along. He doesn't even try to make rational arguments. We all should just take him at his word. Transparency, indeed.
I would certainly agree that the current reform effort has laid bare a considerable failing on the part of the President -- as you say, details appear to be a bother for others to sort out. It appears he'd rather hold more love-in rallies where everyone tells him how great he is than roll up his sleeves and get dirty diving into the nasty business of actual governing. He'd better get a clue fast, or he'll go from "first-to-worst" and find himself out on his rear end after one term.
As for the rest of your comments, I'm too tired to think about them. My son spiked a 104 degree fever last night, spent part of the night at the ER, and oh, when we showed up at his pediatrician's at 7:45 this morning for a follow-up, found out that we had a balance of over $1,000 because Blue Cross/Blue Shield had denied 4 claims from June and July for the utterly baseless reason that we had some mystical "other insurance" that needed to be billed before they would consider payment.
When we called BC/BS just now, they admitted that their position had no merit, and agreed to resubmit the claims for payment.
But in the meantime, they managed to stall payment of over $1,000 to our family physician, cause the physician to warn us that failure to address the issue immediately would cause a stoppage in care, and caused us (only, thankfully) temporary embarrassment -- because I've known the head RN at this office since I was a small boy, and her husband and my dad are best friends.
Thanks, efficient private health insurance company!
Hope he feels better. We had random vomiting one night last week. He took several showers after 10PM.
Just imagine how quickly your doctor will be paid when the payor doesn't have to worry about you changing insurance. The friendliness of the IRS combined with the efficiency of the Post Office.
Actually, one worrisome thing is the IRS snooping in health care expenditures in order to ensure compliance with the tax for mandating insurance.
Thomas Sowell has a good article in IBD today: "'Death Panels' Just A Rumor? Go Ask Ezekiel".
He gives some good background on why these concerns are real. Unfortunately, according to the President, quoting things that he and his advisers said in the past amounts to spreading misconceptions. Which, frankly, is how most of the things he says come across to me.
Post a Comment