This Week’s Podcast: The Great Health Care Reform Debate

I noted here some time ago that tort reform was an absolute necessity if you’re serious about helath care costs. But it is most likely that Obama will simply leave health care providers exposed while he chops their income.
It makes me sick.
And it can make you dead.

Thanks Jake this is very very important!

drjohn
thanks.. there has to be a balance between punishing bad healthcare providers and rewarding voracious attorneys.. don’t envy anyone who is involved in this kind of debate..
..how much of our health dollar goes directly to defending and insuring against liability..

Who you gonna believe?
“The president of the American Hospital Association said Thursday that a deal with the White House to cut the growth in health care spending has been ‘spun way away from the original intent….
“…[I]n a conference call Thursday, President Richard Umbdenstock told 230 member organizations that the agreement had been misrepresented. The groups, he said, had agreed to gradually ramp up to the 1.5 percentage-point target over 10 years – not to reduce spending by that much in each of the 10 years.”

What kind of spending is it on healthcare? People with pain, people with trouble, people with problems getting attention and care. The only downside to federal funding for that is inflation.
At the terminal end, which is where most of the expense is, who is going to decide what can and cannot be done?

Posted by: Thinking | May 15, 2009 10:05:56 AM
Right now everyone is billed for costs hospitals cannot recover- the cost of health care to illegals and to the indigent.
It is terribly myopic to come down hard on hospitals without knowing all of the story.

One of the most readily identifiable species of bottom-feeders in America is the plaintiffs’ medical malpractice bar. They have owned the Democratic Party lock, stock and barrel for decades. The results are eminently predictable.

“At the terminal end, which is where most of the expense is, who is going to decide what can and cannot be done?”
Tom Daschle and Katherine Sibelius
How’s that for scary?
The truth is that if costs are going to be contained, then much if not most of the care given to Mom and Dad near the end will be ended and they will pass 1-2 years sooner than otherwise.
Prepare for it.

Right now everyone is billed for costs hospitals cannot recover- the cost of health care to illegals and to the indigent.
It is terribly myopic to come down hard on hospitals without knowing all of the story.
***************************************
I said Lab work not Hospital. That is go to the lab show your insurance card or pay the bill up front before they draw the blood. Simple. Not at the hospital.

I’ll try to start the reasoning on this, a little.
1)Physicians cannot decide (as much as the quotes make it sound possible)without violating the hippocratic oath.
2)Politicians cannot decide without violating the constitution.
3)Most of the decision making today is done by insurance providers, government and private, in the sense that they have to calculate how much can be spent today and recovered in premiums from others. That’s how they, more or less, determine what to pay on whatever, which is how companies determine their investments in medicine and technology. But that distribution of expenses is also why expenses are run up to the limit. The situation is a lot like housing, where we had all this leveraging on prices that are distributed over a life-time and lifetimes, and not really knowing if those limits were reasonable. Now people are clammoring to lower the premiums, but increase the limits?
(It’s almost unbelievable what a small portion of healthcare is for a little antibiotic or a simple wound, illness or injury treatment.)

Posted by: Thinking | May 15, 2009 10:36:48 AM
Don’t blame those companies. Blame your employer who negotiated the contract with the carrier to stipulate those rules.
That’s how it works.

James Danley:”Just wait until mandatory yearly physical exams is implemented as part of the Left’s preventative healthcare program. That’s 300 million people being required to visit their doctor every year.”
Since every other first world country has a national health care system of some sort and has for decades, surely you can share at least one example where your prediction has happened? Something from reality?

HobokenJohn:”Remember when Obama faced the cameras and told us that he had just talked to the Caterpillar Corporation president who promised him he was going to hire back thousands of workers once the stimulus bill was passed?”
Or remember when a right winger wildly exagerated and inflated a past comment by Obama to make him look bad?
Obama actually said:”Yesterday, Jim, the head of Caterpillar, said that if Congress passes our plan, this company will be able to rehire some of the folks who were just laid off,”
Compare that actual, documented statement with the paraphrase provided by HobokenJohn above and draw your own conclusions on how the right wing exaggerates.

Posted by: Thinking | May 15, 2009 10:57:10 AM
Thinking something is true does not make it true. That’s what wrong with the left.
Pharmacies don’t set deductibles! I don’t know where you come up with these things. They have to abide by the rules given to them by the carriers if they are going to participate in a plan. It lowers costs to the employer if only a 30 day supply is furnished at one time and a new deductible applies each month.
This is always disturbing to those who want someone else to pay for everything and who appreciate nothing.

jhw539 just do the math! Unless there is a dramatically huge increase in the number of physicians, adding 200 million plus appointments for physical exams to the current system will naturally mean much less time available for treating the sick. And that doesn’t even take into consideration the hundreds of millions of additional tests that will be added to the current workload of the labs.
One could argue that over time by detecting diseases earlier it will save on the time necessary for treating the sick. But if true, how much time are we talking about? Is that 10 years? 20 years? In the meantime it will still mean more patients in the waiting rooms; longer waiting times; and healthy people spending more time being exposed to sick patients.

Obama Says U.S. Long-Term Debt Load ‘Unsustainable’
Whats WRONG with this President? Does he have any sense? ON one side of his mouth he says we cant sustain this spending then with the other side of his mouth he comes out with another BIG expensive government program. What a NUT. What a liar. Leading us into debt we can never pay off and will burden us for the rest of our childrens childrens childrens lives. Here comes decades of great society failures and ruined lives AGAIN!

Posted by: ChicagBob | May 15, 2009 11:37:22 AM
Obama absolutely counts on his cult followers to hear his words and ignore his actions.
And for the most part, they do. They pull the wool over their own eyes.

James Danley:”jhw539 just do the math! Unless there is a dramatically huge increase in the number of physicians, adding 200 million plus appointments for physical exams”
Where are you getting this mythical “mandatory” annual physical from? I have pretty good insurance and my doctor only wants to see me every three years or when I am sick or injured.
Again, every first world nation has implemented health care. Why do you have to keep presenting some fantasy world what if scenario to support your opinions?
Getting people of emergency rooms where a team of doctors deals with their care with tremendous resource overkill, like an MRI for a headache, into physicians offices where 10 minutes with the doctor and there done will IMMEDIATELY free up medical resources.

Is there any feedback on the idea of pinning premium limits (including premiums paid through an employer) to some relation of housing costs or values?

Skip, my latest post may not have appeared by the time that you posted your comment. In my latest post I addressed that. I agree there will be some early detection–and that is a good thing. However, there may also be cases where healthy individuals will contract an illness while waiting in the doctor’s office. But the point is that annually adding 200 million plus doctor’s visits to the current number of visits will have a huge impact on the workload of physicians.

Posted by: jhw539 | May 15, 2009 11:57:28 AM
My distortions.
Obama flat out lied and somehow I am distorting something.
Nice try, Mr. Alinsky.

jhw539 do you really think that the Liberals are not considering preventative health care as an integral part of their universal health care? One of the main components of preventative health care is mandatory physical exams. Even former Sen. John Edwards advocated mandatory physical exams during the campaign.
The reason your doctor only wants to see you once every three years is because he knows how swamped he would be if all of his patients saw him every year.
Now then you wrote: “I have pretty good insurance…” The Left’s agenda is for the federal government to be the sole payer in their universal health care program. Even Sen. Hillary Clinton, in one of the debates, said that those who are pleased with their current health insurance will be allowed to keep it…”For Now!”

Skip you missed my point. YES, I agree there will be some early detections like cancer. That is a very good thing! But at the same time healthy individuals may contract infectious diseases (i.e., flu, colds or worse) while sitting around in the doctor’s office for an hour.

James Danley | May 15, 2009 12:45:38 PM
I don’t agree with the way you are quantifying this or weighing risk, by using the word ‘some’ as if it may be a minor improvement when instead there may be a huge improvement, and implying it’s not worth the risk to get a cancer screening because you might catch the flu. You might get sick doing many other less important activities.

Mark- true.
I just keep hearing about how expanding insurance will cut costs because it will lead to prevention. I’d like to see some real numbers on that.
As I’ve brought up before, in California the primary users of emergency rooms for non-emergency care are those insured by MediCal.
And in my own experience, people don’t go to the doctor for preventative care because of the reason I listed, not because they are uninsured.
So again, I’d really be interested to know how much of an effect providing insurance to more people would have in increasing the number of people seeking preventative care or seeking an appropriate place for care.

There’s no way in the world that increasing the money available to healthcare will decrease the money available to healthcare.

If there was, more could be spent right out of the treasury and it would increase revenue, no need for premium increases.

Thanks for the clarification.

For what it’s worth, I believe that Medicare does not cover the cost of an annual physical (correct me if I’m wrong).

On August 12, 2003 the New York Times posed the question, “Are Annual Checkups an Empty Ritual?”
They answered their question as follows:
“Checkups for people with no medical complaint remain the single most common reason for visiting a doctor, according to surveys by the Centers for Disease Control and Prevention. In 2000, they accounted for about 64 million office visits, out of 823.5 million visits over all. At $120 to $150 per visit (and $2,000 or so for the gold-plated ”executive physical” that many companies offer to top executives), that adds up to more than $7 billion a year.
“Yet in a series of reports that began in 1989 and is still continuing, an expert committee sponsored by the federal Agency for Healthcare Research and Quality, an arm of the Department of Health and Human Services, found little support for many of the tests commonly included in a typical physical exam for symptomless people.”
Make of it what you will…

MarkLeavenworth – what do you mean when you say put limits on premiums based on housing?

- Like, we have mandated housing policy guidlines, that a bank cannot get funding for a loan if the loan payment is not within a certain portion of income. Why not make a guidline to plan providers, that a plan premium must be less than a certain portion of housing costs?
==========
Whose housing costs? An individual, or the average of a group, or what?

Another two-faced democrat posturing. One of the large drivers of high health care costs are malpractice suits, including the massive number of frivolous suits that still win in court.
For example, John Edwards spent years and years suing doctors if a child had cerebral palsy, premised on the idea that it was a delivery error.
Lo and behold, and hundreds of millions lost later, we discover that CP develops far earlier in pregnancy.
Who gives that money back? Who makes the physicians whole after robbing them blind, damaging their reputation and in many instances costing them their malpractice coverage.
There was never any proof for the doctor being culpable but juries sit and see a “damaged” child and a rich doctor, and class warfare in the courtroom and award millions and millions.
That is just one slimey lawyer, and just one specific malady. Multiply that over and over thousands of times every day and you see the problem.
Malpractice claims are more about winning the lottery.
No one wants to take away anything from someone who has truly been affected by error, but those cases are few and far between compared to the false, but winnable cases filed.
Trial lawyers, like unions, always receive the protection of the dems….no matter what.
For proof, read the article excerpt below:
—
At issue is the extension of the Protect America Act that was passed last August to allow U.S. intelligence agencies to monitor foreigner-to-foreigner communications without a warrant. Congress has known for six months that this ability under the Protect America Act was set to expire on Sunday. So last week, by an overwhelmingly bipartisan majority, the Senate passed legislation to prevent the authority from lapsing.
But the House Democratic leadership, led by Speaker Pelosi, refused to let the House vote on the bill. This led to a House GOP walk out led by Minority Leader John Boehner (Ohio), who said, “We will not stand idly by and watch the floor of the United States House of Representatives be abused for pure, political grandstanding at the expense of our national security.”
Why? Not because the bill lacked bipartisan support, but because it lacked trial lawyer support. The Senate-passed bill contains a provision granting immunity from lawsuits to telecommunications companies that have been cooperating with the government in the War on Terror.
Instead of putting her fellow Democrats in a position where they have to make a public vote in favor of trial lawyers over the safety of Americans, Speaker Pelosi opted to leave Washington for vacation.

So people with more expensive houses would have to pay more for the same health insurance coverage?
And people who’ve owned their homes for a while would get to pay less in insurance premiums?
I don’t know why home price and health care should be tied together. Isn’t that just a backdoor way to tie premiums to income?

If they wanted a slightly better plan without paying for it out of pocket, they could move into a slightly less affluent neighborhood. But even at that, the government limit would be forcing them to keep more of their estate, while providing a not too extreme, but more powerful over time, incentive to the industry to provide better healthcare to those least able to afford it.

“Hospitals and insurance companies said Thursday that President Obama had substantially overstated their promise earlier this week to reduce the growth of health spending.”
Huh? Obama is now overstating the promises of others as well as his own? What’s going on here?

Skip, where did I say, “…it’s not worth the risk to get a cancer screening because you might catch the flu?” My whole point is that MANDATORY annual physical exams are going to keep doctors so busy that they will spend more time giving physical exams then actually treating illnesses.
Read all of my comments please. I said that early detection is a good thing. I was just pointing out that with 200 million plus more people having doctors appointments annually that the waiting will be longer, thus healthy people will be subjected to spending a lot of time with sick people. I am not against screenings and physical exams. Just don’t force 200 million plus people to overload the system.

“On August 12, 2003 the New York Times posed the question, “Are Annual Checkups an Empty Ritual?”
They answered their question as follows:”
They did not answer it they provided several views on the issue which will be clear to anyone who reads the article.

JonF- They have been trying to sort of socialize the premiums through employer plans without people realizing it. But if you look at the outcomes, you are talking about no one ever being able to work for themselves again, having an unlimited personal premium to match the competition from corporate group plans. The part that gets out of line with what people can really afford is the problem of placing limits on healthcare, especially terminal care, and the fact that there is very little pay-over the counter kinds of transactions. In fact, it is not legal for a health care provider to bill directly for services in California, they have to bill through an insurance provider, which also points to the socializing agenda. The real question for all of us is who sets the limits, and how are they set. I have put up a suggestion for making that a transparent issue, and I’m looking for feedback. If there is any question in the public mind about wether the government or the industry is more fit to run healthcare once the limits are set, well, then you and I have a common enemy. I’m pretty sure most of us are not that stupid.

I have no health insurance. This makes me feel insecure. If it happens I give thanks to all who support this. Is this going to really happen?

Why ABC News did not cover the recent episode in which during Senate Finance Committee hearing people supporting Single Payer health care system were ejected from senate chambers? Those Senators were irresposibally making jokes of these people by laughing at them.
Why so called free media did ask those Senators questions like Why these group of people were not invited to the table to present their views? There were representation from Health Insurance Industry and pharmacetutical Industry. I wonder why? Can ABC News investigate about this?
Is ABC News really reporting freely on Health care issues? I do not think so. There is no balanced reporting on health care issues by ABS News. It is really shameful.
ABC News should be ashamed of themselves for not being unbiased on health care issues.
I believe that they are in pocket of (totally controlled by) pharmacetical Industry because they are their best customers providing them millions of dollars in unnecessary advertisement revenue during World News every evening. Therefore, they cannot expose the phramcetiucal industry. They have to cover (hide)their deeds and misdeeds.
What kind free reporting is this?
Can I get response to this e mail please?
Thanks.

Sandcrab1612- Was that last line ‘there is no way they can get this kind of money with a tax increase on the entire population’ or ‘the only way they can get this money is with a tax increase on the entire population’?>

What I would like to know is, who in the Hell planned these demographics for us?!

As far as the federal government cost of health care to its own employees you can Google FEHB and see what the different plans available to federal employees are. It should be noted that these are the same exact plans which are available to our elected federal officials. The government does not pay 100% of the employee health insurance and the portion they pay is considered a benefit in lieu of wages just like most major employers who provide a health benefit to their employees. Usually the larger the company (more employees) the more likely is that they provide the health insurance rather than paying the larger wage as most employees would rather have access to the health insurance instead of the small increase in wages. For an employee in California with a family looking at an HMO (California Health Net, High Option) this amounts to roughly $4.40 an hour. For the same family in California looking at a FFS (Blue Cross Blue Shield Service Benefit Plan, Standard Family) this also amounts to $4.40 an hour. Small business’s which have fewer employees cannot afford to offer this type of benefit to their employees without having to make drastic cuts (layoffs# or drastically raise the price of their finished product/service both of which will probably cause the business to fail in time due to lack of profit. The federal employee still has to pay to participate in the insurance #$292 a month for the HMO and $357 a month for the FFS# so the government does not provide 100% of the insurance to the government employee. Probably the best that the government could do for health care would be to somehow expand the FEHB type of insurance for the general public to participate in but with no government funding for the general public. You have to remember that the federal employee is receiving his government share of the insurance funding as part of his wage and benefit package and performing labor in return, the general public would provide no benefit to the government for any government funding of their health care. Perhaps another question you may want to ask yourself is how much would I pay for healthcare insurance? Would you pay $1055.00 per month to be able to partake of the HMO I used as an example? Would you be willing to pay $1120.00 per month to be able to participate in the FFS I used as an example? If yes then maybe the answer is not government paid healthcare but the government allowing all citizens to participate in their healthcare programs at their own expense #they would have to pay the total of what the government pays for their employee plus what the employee pays). I would imagine that there are some plans which would be cheaper but they might not offer the same level of health care as a more costly one. If this was the way they go then it would be up to each individual to carefully compare costs and benefits between plans before making possibly a wrong choice.

Sandcrab1612- Thank you for the time you’ve taken with that. What do you think is the best way to limit the investments we make in terminal care, seeing that there is almost no limit, naturally, to the investments we can make in trying to keep someone alive who is terminally ill?

Sandcrab1612- With my father, it was a long process of physicians coming in with updates and always saying ‘we have this chance’ or ‘we have that chance’. It was later that I realized, they MUST build their lives on hope in the midst of death on an hourly basis. They are on the front lines of death in every terminal case, and their whole lives are devoted to preserving life. None can expect a physician to give an estimate for the probability of death. That is what could be referred to as the hippocratic oath. Clearly, if limits are to be imposed, they cannot be imposed on a case by case basis, and certainly not by physicians. It is this limiting function which I believe should be made transparent and far enough away from the individual cases so that the hospital, or groups, must base their decisions on what they have available. Ultimately, that limit will be our ability as a nation to absorb inflation, and how we are going to do that is also necessarily a matter for public debate and discussion.

It is interesting to note that Canadian health plan has lots of rationing but would the populace vote for our style of health care? Doubt it…despite their flaws, they would rather have their system than ours. Interesting to note that most European countries also have socialized medicine…why aren’t their citizens requesting for American health care system?

Put another way, we will be yelling and screeming to get more from our healthcare dollar, and finding ways to meet those demands, forever…hopefully with at least as much spirit as egyptians at an open market. People that have no influence over the prices and values of what they get have little reason to complain.

Formerflowerchild, “The lions share of the billions of dollars in President Obama’s health care reform budget will go into the pockets of government union workers while everyone else will get the shaft.”
Not only that, as government union workers get more and more of the health care dollar the amount spent on providing actual care to the people will go down and people will be left with less and less health care at higher and higher costs.
President Obama has a track record of making sure his main supporters, unions, get the lions share of any deal. Just look how he shafted the Chevrolet Bond holders when he ignored the rule of law in contract law in order to benefit the auto union. Look at what President Obama is doing in California by threatening to withhold stimulus funds if California goes through with laying off government union health care workers. The same will be true in any health care reform plan if people do not wake up before it is too late. President Obama will do anything to pay back his union supporters at the expense of everyone else.

Thatsthetime, kay, & formerflowerchild – I believe that you are mixing apples and oranges. “Government union workers” which you all refer to is a misnomer, there are federal government workers (those who are on the government payroll) and union workers (those who are members of a union but DO NOT work on the government payroll). The health insurance available to federal government workers can be found by Googleing FEHB, the plans listed are the plans available to ALL federal employees including members of Congress. Members of Congress do not have a separate plan from other federal government employees, this has been the way it is for them since passage of the 1983 Civil Service Reform Act. Union workers receive their healthcare insurance through their employer and in the case of the auto companies the government is not the employer they are a stockholder.

Yes, we’ll have government run health care and be paying 75% of our income in taxes. Has anyone in the Obama administration ever noticed that this country is really really broke?
If we are truly a democratic nation, then why are we talking about state run health care – rationed as if it were boots in Russia during the Cold War.

Wow! What rock are all of us living under?
As far I’ve been able to find out, it is virtually IMPOSSIBLE to sue for damage done by the medical industry, since the passing of the FDA preemption four years ago. This includes all of the “mistakes” done by doctors. How can these insipid doctors keep trolling around about this fraud, saying that they are “practicing defensive medicine”? What a great cover to waste your money!
From my viewpoint and after years of being harmed by the police state medicine that we are subjected to now, I DO NOT support socialistic “insurance”. For all of the comments from the distracting pundits, more protection to the “bad” doctors and giving “free” drugs to everyone will complete the task of bringing the country down – healthwise and financially wise. The only positive point that I’ve read from all of the comments is that the UK has finally come to their senses that “preventative” medicine does more harm than good and is extremely expensive. This only provides the illusion that these “preventative tests” are accurate. We treat cancers and other diseases that have no hope of recovery and we treat cancers that are not there. We treat vitually every “mental” disease, real or not, when there is no concession of when to treat with drugs. We brainwash everyone with endless commercials, so that everyone believes that their lives depend on many drugs.
As I’ve posted on many websites, we need to:
1) STOP the advertising on the TV. This will save trillions every year.
2) STOP the protection of “bad” doctors, by the FDA preemption and the endless legal remedies that they have to protect themselves. I don’t know that this will save money, but it will save lives. If doctors don’t like being sued, there is always jail.
3) Make it illegal for the insurance companies to be front companies to defraud patients.
4) Get involved in what the politicians are doing to the “disabled”. This is the most horrendous way to treat people. Since I’ve been harmed, deeply and permanently, by the medical industry (and yes, this was clearly improper treatment), I’m eligible to get SSDI. But only if I give away my home for unnecessary medical “expertise” that the government mandates. If I do this, the only way to have a roof above me, would be check into the nursing home at the tune of $75,000+++/yr (I can’t pay for this waste, can you guess who would pay for this?). I’ve been illegally fired from my job – again, without no redress; I’ve had my retirement taken away forever – no redress; I’ve been scammed out of the rest of my life savings by the Vocational Rehabilitation – no redress. Believe me, all of the money that we are pouring toward the “disability” issues are not getting to the “disabled”. HOW DUMBER CAN WE GET?
4) And finaly, take some responsibility for your actions. Just because your doctor is pushing drugs and “preventative tests”, or just because the drug companies are pushing drugs, that doesn’t mean that these drugs are health food. Follow the money.
Sorry for the long post, I’ve probably taken a little time from you to take your statins, or Viagra, or your antibiotics, or your SSRIs, or your antidepressives, or whatever. We should be the healthiest people on the planet, if the advertisements were actually true. Instead, we are stumbling around in drug fogs, whining that we need more drugs. Please don’t only rely on your doctor for his advice, he’s making a great living on harming you and picking your pockets.

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