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Patvann
14 years ago
@Mike
Easy, big guy..I was the one who wrongly called him a liar. (lier…stupid spellchecker ;-))
@Larry
1. In my haste to read your post, I failed to note that you pay for more than your immediate family, and that you pay for extra coverage. I apologize for this, and will strive to be more careful next time (No scanning!), and keep my emotions in check, regardless.
Again, my bad.
2.Thank you very much for the offer of consultation. I know your time is your money, and the offer means a lot. In light of #1, it is a very gracious offer.
3. 59.03 sec 100m Fly in Dec of 78. Top that! (Oh g-d that was a long time ago! 🙂
Now back to the joust…
Do you think if Obamacare passes you will be able to keep that coverage (Congress calls it “Cadillac-care”) without being taxed to bejeezus for it?
According to my policy, Kaiser will cover equipment they don’t have (But I’m sure they will soon enough) at 80%. I also don’t ever see using up a mil out of network. 99.99% of the time, out of network usually means an emergency-room somewhere, where I have no choice in where the ambulance takes me.
Medicare is broke, Medicare can cross State lines, I have no problems with their service, I have a problem with it’s fiscal management, and the fact that private plans have a different set of rules. (Kaiser is also non-profit, but you probably know that.)
Look over the lists I’ve made in the other thread. I could fix this mess in one page. The REAL problem I have with this Bill is that it has NOTHING to do with “fixing” how healthcare gets paid for… I wonder how much you pay each year to keep the Tort-trolls away from your checkbook?
It’s all about power for the Democrats, period, and I stand by my previous posits.
Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.
The poll contradicts the claims of not only the White House, but also doctors’ own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.
It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration’s claim that the government can cover 47 million more people with better-quality care at lower cost.
The IBD/TIPP Poll was conducted by mail the past two weeks, with 1,376 practicing physicians chosen randomly throughout the country taking part. Responses are still coming in, and doctors’ positions on related topics — including the impact of an overhaul on senior care, medical school applications and drug development — will be covered later in this series.
Major findings included:
• Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration’s claims that doctors are part of an “unprecedented coalition” supporting a medical overhaul.
It also differs with findings of a poll released Monday by National Public Radio that suggests a “majority of physicians want public and private insurance options,” and clashes with media reports such as Tuesday’s front-page story in the Los Angeles Times with the headline “Doctors Go For Obama’s Reform.”
Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the “association representing the nation’s physicians” and what “many still regard as the country’s premier lobbying force” — is “lobbying and advertising to win public support for President Obama’s sweeping plan.”
The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA’s support of Democrats’ proposed health care overhaul.
• Four of nine doctors, or 45%, said they “would consider leaving their practice or taking an early retirement” if Congress passes the plan the Democratic majority and White House have in mind.
More than 800,000 doctors were practicing in 2006, the government says. Projecting the poll’s finding onto that population, 360,000 doctors would consider quitting.
• More than seven in 10 doctors, or 71% — the most lopsided response in the poll — answered “no” when asked if they believed “the government can cover 47 million more people and that it will cost less money and the quality of care will be better.”
This response is consistent with critics who complain that the administration and congressional Democrats have yet to explain how, even with the current number of physicians and nurses, they can cover more people and lower the cost at the same time.
The only way, the critics contend, is by rationing care — giving it to some and denying it to others. That cuts against another claim by plan supporters — that care would be better.
IBD/TIPP’s finding that many doctors could leave the business suggests that such rationing could be more severe than even critics believe. Rationing is one of the drawbacks associated with government plans in countries such as Canada and the U.K. Stories about growing waiting lists for badly needed care, horror stories of care gone wrong, babies born on sidewalks, and even people dying as a result of care delayed or denied are rife.
In this country, the number of doctors is already lagging population growth.
From 2003 to 2006, the number of active physicians in the U.S. grew by just 0.8% a year, adding a total of 25,700 doctors.
:snip:
Adding millions of patients to physicians’ caseloads would threaten to overwhelm the system. Medical gatekeepers would have to deny care to large numbers of people. That means care would have to be rationed.
:snip:
Hope for a surge in new doctors may be misplaced. A recent study from the Association of American Medical Colleges found steadily declining enrollment in medical schools since 1980.
The study found that, just with current patient demand, the U.S. will have 159,000 fewer doctors than it needs by 2025. Unless corrected, that would make some sort of medical rationing or long waiting lists almost mandatory.
Experiments at the state level show that an overhaul isn’t likely to change much.
On Monday came word from the Massachusetts Medical Society — a group representing physicians in a state that has implemented an overhaul similar to that under consideration in Washington — that doctor shortages remain a growing problem.
Its 2009 Physician Workforce Study found that:
• The primary care specialties of family medicine and internal medicine are in short supply for a fourth straight year.
• The percentage of primary care practices closed to new patients is the highest ever recorded.
• Seven of 18 specialties — dermatology, neurology, urology, vascular surgery and (for the first time) obstetrics-gynecology, in addition to family and internal medicine — are in short supply.
• Recruitment and retention of physicians remains difficult, especially at community hospitals and with primary care.
A key reason for the doctor shortages, according to the study, is a “lingering poor practice environment in the state.”
In 2006, Massachusetts passed its medical overhaul — minus a public option — similar to what’s being proposed on a national scale now. It hasn’t worked as expected. Costs are higher, with insurance premiums rising 22% faster than in the U.S. as a whole.
“Health spending in Massachusetts is higher than the United States on average and is growing at a faster rate,” according to a recent report from the Urban Institute.
Other states with government-run or mandated health insurance systems, including Maine, Tennessee and Hawaii, have been forced to cut back services and coverage.
This experience has been repeated in other countries where a form of nationalized care is common. In particular, many nationalized health systems seem to have trouble finding enough doctors to meet demand.
In Britain, a lack of practicing physicians means the country has had to import thousands of foreign doctors to care for patients in the National Health Service.
:snip:
British doctors, demoralized by long hours and burdensome rules, simply refuse to see patients at nights and weekends.
Likewise, Canadian physicians who have to deal with the stringent rules and income limits imposed by that country’s national health plan have emigrated in droves to other countries, including the U.S.
It’s all about power for the Democrats, period, and I stand by my previous posits.
Larry, when it comes to medicine, no question, you are the “gifted gold standard.” Why or how someone as brilliant as you are is not the least bit concerned about the ‘corrupt thugs ‘who will be overseeing “healthcare reform”, is a total enigma. This is far bigger than perscription drug or even Medicare; 1/6 of the entire economy to be exact.
Most of all, it is UNDOABLE; at least in our lifetimes. What are the chances that after half the country is either employed, compensated, or benefited other ways by “Obamcare”, anyone is going to vote anything other than democrat? They, in all of their corruption, will OWN us for the rest of our lives. Consequently, we will have to live with tax payer funded abortions, and life or death decisions, regulated by HHS, i.e, currently Kathleen Sebelius, who’s election btw was funded by “Tiller the Baby Killer.”
Do you ever stop and think about the people BEHIND the scenes, the real decision makers? Do you really believe, based on 9 months of Obama telling us one thing and doing another, that the people behind this can be trusted? I know you hate it when I agree with Palin on the “death panels”, but does it not bother you that the language she was referring to was written by a euthanasia supporting congressman from Oregon, only recently discovered? Does it not bother you that, unlike what they want us to believe, abortions WILL be paid for by tax payers?
And all of that is just for starters. The halllmark of this administration is the relegation of human life. You more than anyone on this blog understand the places biotech is going; when no man has gone, and with no regulations. Watch for the Dickey Wicker amendment to be overturned next ,after “health care passes of course”, and all bets are off on “human experimentation.” Before your first grandkid is born we will have “fetal farms” where ’embryos’
are grown for ‘spare parts’. Not long ago, I referenced an article out of the ‘esteemed NEJM’, the medical journal you agree as being the cream of the crop. Here’s an excerpt:
The New England Journal of Medicine has become the latest publication to publish an opinion piece that, in essence, tells physicians who don’t want to violate the Hippocratic Oath to get out of areas of medicine where non Hippocratic procedures are now allowed.
Why would the NEJM run such an “opinion piece” if what I’m claiming is “scare mongering?”
Gosh, even “swine flu” creeps me out. Is it just me, or is there just a little too much “hype and certainty”that just may contribute to the death, or dare I say, sterilization, of many of us?
And how about the elderly? They more than anyone have paid all of their lives into Medicare, only to come into their sunset years and be given the Obamcare line that “A 25 year old has much more worth than you, consequently, your hip repleacment, or heart sugery, simply isn’t ‘economical’. I agree that currently, Medicare is a good thing. But to think it is going to “stay as is or improve” is a pipe dream; not under these thugs.
I could go on endlessly, pointing out why the “people in front and behind the curtain” are not to be trusted. PatVann is right. It is ALL ABOUT POWER. And what is more of a “power statment” than who controls human life, from conception (embryo), to ‘natural death’?
We don’t and never had a “population” problem. Resources are more plentiful than ever, and even if they weren’t, who are any of us to decide for our Creator. Our only problem is a morality problem, from which all others follow. Under the Obama adminsitration, “healthcare” will not only be the death of many of us, it will be the death of America .
Like most Americans, I’m totally for health care reform, but not at the expense of human life, which, ironically, is what “Obamacare” AND POWER, is all about,
@Aye (#103): Can you provide a link? There’s a lot in that which is just plain wrong, but I’d like to read and seriously consider it, before responding. – Larry W/HB
given the Obamcare line that “A 25 year old has much more worth than you, consequently, your hip repleacment, or heart sugery, simply isn’t ‘economical’.
It’s a questionnaire — not a scientific survey; how do I know this?
“Responses are still coming in.”
Some factual errors:
It also differs with findings of a poll released Monday by National Public Radio that suggests a “majority of physicians want public and private insurance options,” and clashes with media reports such as Tuesday’s front-page story in the Los Angeles Times with the headline “Doctors Go For Obama’s Reform.”
It wasn’t a “National Public Radio” poll. It was a scientific survey, with methodology passing stringent statistical peer review, conducted by the Mayo Clinic and the University of Chicago, and published in the New England Journal of Medicine.
Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the “association representing the nation’s physicians” and what “many still regard as the country’s premier lobbying force” — is “lobbying and advertising to win public support for President Obama’s sweeping plan.”
The LA Times story was centrally about the Mayo/Chicago study (I provided a link to the full text of this study). As part of the story, it included related background information about the official position of organized medicine, through the AMA.
The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA’s support of Democrats’ proposed health care overhaul.
I think that the AMA membership is about 30% of America’s doctors. There is a lot of internal dispute: it’s chiefly a battle over the “pie.” Right now, procedures get reimbursed generously (i.e. surgeons, interventional radiologists, and the like), while primary care is reimbursed poorly. There is a nationwide shortage of primary care doctors and a surplus of surgical specialists. So health care reform (which includes Medicare reform) calls for “redistributing” (through changing reimbursement formulas) reimbursement from procedures to primary care medicine. Of course, this puts the primary care doctors on board and puts the surgeons on the other side. One can’t possibly evaluate the Investors Business Daily poll without detailed information as to percentage of respondents which were in each type of medical specialty and how these percentages stack up against national figures. These data were provided in detail in the Mayo Clinic/U of Chicago study, but not in the Investors Business Daily poll.
• Four of nine doctors, or 45%, said they “would consider leaving their practice or taking an early retirement” if Congress passes the plan the Democratic majority and White House have in mind.
This is utterly ridiculous and has no credibility whatsoever.
More than 800,000 doctors were practicing in 2006, the government says. Projecting the poll’s finding onto that population, 360,000 doctors would consider quitting.
This is utterly ridiculous and has no credibility whatsoever. You’ve got people who have invested a dozen or more years in post-high school education and they are going to bail because their incomes might possibly drop from $300K to $200K? And, as I noted above, the doctors who’s incomes might drop most are those who are in oversupply and the doctors who’s incomes are likely to rise are the doctors in the shortest supply.
>>Hope for a surge in new doctors may be misplaced. A recent study from the Association of American Medical Colleges found steadily declining enrollment in medical schools since 1980.<<
This makes it sound as if people are reluctant to go into medicine. Not true. This is because medical schools nationwide reduced enrollment by 20-33% in the early 80s because of fears of a "doctor glut." Med school admissions have never been more competitive than they are today.
n.b. Compare "applications" (number of people applying) with "Matriculants" (number of applicants accepted and enrolled)
Here in California, a single "B" in organic chemistry is viewed as a death knell for successful admission by pre-meds.
I can't comment further until I can actually see the actual details of the poll methodology. But the article itself is obviously written with a strong point of view.
PDill's message is more about abortion and anti-Obama sentiment than about health care reform, per se. How do I respond to "Obama is evil?" I am supposed to say "No, he isn't?" So it wouldn't be a productive discussion.
Larry, I wish you would focus more on the “overall big picture” of the types of people running the show, instead of trying to defend your POV by whitewashing soundbites and symantics.
For the life of me I can’t fathom how you don’t “get” these guys, especially considering your expertise in medicine and reputation for ethics and good character. PLEASE Larry, at least in this most critical crossroad of American politics, dare to go where liberals just never seem to go, and look at the BIG PICTURE.
You may be a bleeding heart liberal, but you are not a radical, and that’s who’s calling the shots here, LEFT WING RADICALS! Maybe you need to spend some time reading the writings of people like Holdern, Zeak Emauel, Cass Sunstein, Peter Singer, and of course, the “non accountable” czars.
Yet at least two of President Obama’s top health advisers should never be trusted with that power.
Start with Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel. He has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research.
Emanuel bluntly admits that the cuts will not be pain-free. “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick’ cost control, more for show and public relations than for true change,” he wrote last year (Health Affairs Feb. 27, 2008).
Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, “as an imperative to do everything for the patient regardless of the cost or effects on others” (Journal of the American Medical Association, June 18, 2008).
Yes, that’s what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.
Many doctors are horrified by this notion; they’ll tell you that a doctor’s job is to achieve social justice one patient at a time.
Emanuel, however, believes that “communitarianism” should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those “who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia” (Hastings Center Report, Nov.-Dec. ’96).
Translation: Don’t give much care to a grandmother with Parkinson’s or a child with cerebral palsy.
He explicitly defends discrimination against older patients: “Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years” (Lancet, Jan. 31).
Dr. Emmanuel can have whatever personal views he wants; he doesn’t run the country. He doesn’t have any power at all over Medicare.
The GOP was in control of the country for 6 years. I give George W Bush credit for wanting to do something about health care, but his own party wouldn’t go along with him.
We truly do have an unsustainable health care mess in this country. It’s a global problem, caused mainly by technology explosions. But, of all the Western nations, we’ve got the greatest problems. Private insurance funded health care is actually leading the public sector with respect to “rationing,” as I’ve repeatedly tried to illustrate.
You are so worried about government “death panels;” well, that’s never going to happen, because we do have a Constitution and it doesn’t include a dictator. But private insurance companies have their own dictators and no one can do anything about them. And health care is immune from the economic principles which control corporate behavior and the behavior of salespeople in the sectors of the capitalist economy which do, indeed, work extremely well.
So you are willing to let the current rotting system continue to rot ad infinitum because Obama is evil and he’s surrounded by evil people and they are going to do evil things to us?
I can’t respond to thinking like that.
– Larry
Patvann
14 years ago
@Larry
RE:107
@pat:
given the Obamcare line that “A 25 year old has much more worth than you, consequently, your hip repleacment, or heart sugery, simply isn’t ‘economical’.
Can you provide a link for the above quote?
I am afraid that was not one of my comments.
My first response to it though, is that that line is NOT in any Bill, but is one of the theories explored by Obama’s Science Advisor in a book he published a while back.
If you like, I will find the actual quote, in its complete context.
Patvann
14 years ago
@Larry
Found it…
The full quote is by Ezekiel Emanuel:
Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-yearolds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.
It is from a report in The Lancet, earlier this year: Here
You may also find this quote by him interesting (from Hastings)
This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.
The biggest problem that our healthcare system has is that it is expensive. Tort reform is the obvious answer.
Not creating a godzilla-like socialist health care option that would offer free healthcare. How are private insurance companies supposed to compete with such a well-funded and well-connected entity that offers the same product for free?
As past statements by Obama, Frank and many other Democratic Party politicians reveals… the public option method is the best way to achieve a single payer healthcare system. All this mambo jumbo about increasing competition is nothing but a lie.
The biggest problem that our healthcare system has is that it is expensive. Tort reform is the obvious answer.
We’ve had tort reform in California for 30 years. Cap of $250,000 on pain and suffering. No punitive damages. You can’t really do more than that. You have to compensate people for actual damages (medical expenses and lost wages) secondary to negligence. They’ve also had tort reform in Texas for several years, modeled after California’s. There is no evidence at all that this has reduced ordering of unnecessary tests for defensive medicine or saved the health care system any money.
Below is a very excellent article, which should provoke some thought.
About 1/3 of all Americans will get cancer. Of these, about 25% will exhaust their savings or nearly exhaust their savings in treating the disease.
“Even among families with health insurance, 33% of the respondents” (in a Kaiser Foundation and Harvard School of Public Health study) “said they struggled to pay medical bills.”
Another interesting statistic: “Medicare spends one-third the total cost of treating cancer in the final year of life and 78% of that spending occurs in the final month.”
I’m not sure what the answer is, but it’s neither the status quo nor “malpractice reform.” I do know that’s it’s a real shame that we are wasting so much energy on screaming about red herrings like “single payer” (ain’t gonna happen, no way. Where we are headed is continental Europe and not Canada nor the UK). And “rationing” (already going on, and mostly in the private sector). And “death panels.”
CA is a bad example for your argument Larry. It actually proves the opposite of what you assert.
First off, the reform in CA has been demonstrated to save a lot of money (Texas still has reform problems).
Secondly, California is one of the only 5 states that the AMA deems to be OK as far as tort reform goes.
From 1986 to 2000, premiums fell 12 percent in California, while rising 55 percent nationally (in inflation-adjusted dollars). During that same period, rates in Florida rose 809 percent; in Nevada 8,375 percent.
Trial lawyers have been fighting this for years. Lets make CA’s MICRA national and put the brakes on medical malpractice abuse which causes the defensive medicine that helps make health expensive.
“In California two years ago, an OB/GYN paid on average $47,500 for malpractice insurance. In Florida, she paid $173,000. Neurosurgeons paid $68,436 in Los Angeles County, but $278,829 in Dade County, Fla., and $163,000 in suburban Detroit and New York. In California, an orthopedic surgeon paid $22,730, but in Pennsylvania $90,297.”
The average jury award has now increased to about $3.5 million nationally, with about 57 percent of that going to attorneys’ fees. By comparison, the California Department of Insurance says the state’s malpractice insurers made a 1 percent profit between 1991 and 2000. Insurers annually pay as much as 40 percent more in claims than they receive.”
I’m glad that you are so confident that we are not headed for a single payer system even though our top leaders have expressed their desire to use the introduction of a public option as a means to single payer.
You must have a lot of confidence that the Tea Party movement will prevent the Democratic Party leadership from realizing their cherished goal of a single payer healthcare system. Good for you…
@Freedom now: My point was that CA malpractice reform neither reduced ordering of “defensive” tests nor had any demonstrable effect on lowering health care costs or increasing health insurance affordability (I previously gave a link for this). What it did was to allow providers to make more money, which is useful in CA, where real estate and cost of living in areas where doctors tend to live is pretty high.
Here’s what I was responding to, your statement that:
The biggest problem that our healthcare system has is that it is expensive. Tort reform is the obvious answer.
I’ve stated several times that I’m totally on board with the concept of CA-style being a good thing, but the idea that malpractice reform is the solution to “the biggest problem” in our healthcare system is fanciful.
Boyo… feel like I get to poke my head in the party door for a minute, catch up, make a comment and gone. Sorry can’t stay more in depth, of late. But Mr. Larry…
What it did was to allow providers to make more money, which is useful in CA, where real estate and cost of living in areas where doctors tend to live is pretty high
Now Larry, this not only isn’t based on any fact, it’s pretty unflattering an attitude you have there. First of all, the only fact we do know about the malpractice reform is that is brings down a physician’s E&O insurance. You happen to translate that as allowing them to engage in fat cat lifestyles.
So allow me to pose an alternative for you. I could also make the claim that many of these doctors were so underwater financially from the high E&O, plus taking Medicare patients and low reimbursements, that this savings on their E&O allowed them to continue to take Medicare patients… or even stay in business.
I’d say my view of a doctor’s savings on his operating expenses is just as based in fact as yours… perhaps more since you, yourself, know that doctors either opt out of Medicare for financial reasons, and that E&O costs an arm and a leg. Your view, on the other hand, is just kind of a weird judgmental aspersion…. Which becomes even more hilarious with you think that the majority of the medical professional is traditionally Democrat, and not those evil rich corporate Republicans.
I’ve stated several times that I’m totally on board with the concept of CA-style being a good thing, but the idea that malpractice reform is the solution to “the biggest problem” in our healthcare system is fanciful.
I think most of us realize there is no one magic bullet. However when you combine the savings of malpractice tort reform, “hope” for control on Medicare fraud, allow wealthy over 65 seniors to opt out of Medicare without penalty, etc etc…. none of which costs the taxpayers a dime…. we might see some results. It will take many things.. and none of them need include a public option.. nor a mandate that employers provide insurance or pay fines.
There is no need to reinvent the wheel here… which is “da plan”.
@mata: What I said was that CA and Texas reduced malpractice premiums, with no evidence at all that they reduced defensive medicine or overall health care costs. I’m sure that it did have marginal effects. I agree that malpractice reform is a good idea, but it’s at most a drop in the bucket
As far as allowing wealthy over 65 to “opt out” of Medicare, why on earth would they ever want to do that, as Medicare is, quite simply put, the best health insurance plan available at virtually any cost? With regard to Medicare “fraud,” this is a health system-wide problem and not simply a Medicare problem. The GOP controlled government for 6 years and never began to make a serious effort to solve any of the health care problems, just as they made no serious effort to solve energy problems (this latter is not my criticism, but is a criticism expressed by my own very conservative GOP congressman, Dana Rohrabacher, in one of his frequent “town meetings” by telephone, in which I participated).
So you’ve offered three potential solutions (above) — but I don’t see these — even collectively — making a tiny dent in the existing problems, to say nothing of the impending problems.
– Larry Weisenthal/Huntington Beach, CA
P.S. Who knew that MDs were “traditionally Democrats?” I didn’t. It is true that MDs have grown less conservative over the years, chiefly as a result of increasing number of women entering the field. In my own personal experience, female doctors tend to be less conservative than male doctors. This is going to keep increasing, by the way. When my sister was a medical student, there were 8 women and 200 men in her class. With me it was something like 28 women and 190 men. Today, at the same medical school (the U of Michigan) the majority of the entering classes are women. It’s a huge demographic shift. Women tend to be less likely than men to enter medicine for the promise of hefty financial rewards. Certainly that’s the case with my own female doctor-to-be offspring.
@Mike: I was best man at a wedding of two doctors. Gal lots more liberal than guy. But it’s all just anecdotal chit chat. In my spare time, I’ll try to find some survey/study. Are the pediatrician/OG GYNs you quote South Carolina residents? I’d imagine that they’d trend more conservative than those in CA.
By the way, your comment (somewhere else) about one of Nate Silver’s criticisms of the IDB/TIPP survey was on target. All (or virtually all) surveys of doctor’s opinions are in the form of written questionnaires, typically including a small honorarium. I’ve filled out several Robert Wood Johnson -sponsored surveys myself. They are typically quite detailed, including lots of questions which don’t make it into the published surveys, presumably to in some way provide some quality control regarding responses. I can’t imagine any doctor who’d be willing to answer phone questions from a stranger about medically related political opinions.
@openid.aol.com/runnswim: I grew up in Ohio surrounded by my father’s OB GYN colleagues. And my cousin works in Ann Arbor, Michigan, a bastion of liberalism.
So Nate didn’t jump all over the Robert Wood Johnson mail in survey? GOLLLLEEEE! I am SOOOO suprised!
Will you remain paralized with indecision? What kind of reform do you suggest, if you suggest none?
What you are trying to do is blow smoke to deflect away from something that did work. Tort-reform has dramatically lowered premiums for medical professionals in CA (save the propaganda, you admit that this aspect of reform worked, but cite the above reason to IGNORE IT).
Most of the rest of the country does not have effective tort-reform. Do you suggest witholding a model of reform that has worked?
I agree that tort reform has had benefits in CA (for providers, who have increased their take home pay), but this has not reduced the ordering of defensive tests nor lowered health care costs for businesses or individuals. OF COURSE IT IS WORTH DOING (I AGREE with you on that), but it’s really a side issue. I think that you (or someone else) claimed that malpractice reform was supposed to be a big part of the solution to reducing health care costs. This is certainly the current GOP party line, among those who are asked, well, if you are against Obama’s plan, then what is YOUR solution?
The answer is that it’s been tried, in California, which is 10% of the nation’s population, and also in Texas, another big state. In neither case did it make a dent in costs to the health care consumer or reduce the ordering of defensive medicine tests. The latter should come as no surprise — malpractice awards are plenty high without there being punitive damages and pain and suffering awards — there is more than enough incentive, even in the presence of malpractice reform, to continue to practice defensive medicine.
Name something substantial in Obama’s plan that has been demonstrated to reduce medical costs and be honest, giving free healthcare costs to individuals comes with (not so) hidden costs. Therefore, businesses and individuals still pay for Socialized medicine (even limited Socialized medicine like the public option). It is a huge financial burden on the government, which must be supported by taxpayers and leads to a lower quality of healthcare.
So whats next, free housing? Housing is a problem too.
History has proven that ‘Bread and Circus’ does not work as a longterm solution. Furthermore, YOU HAVE NOT EVEN ADDRESSED THE FACT THAT OUR LEADING DEMOCRATS HAVE PROPOSED MANY TIMES IN THE PAST TO INTRODUCE THE PUBLIC OPTION AS A MEANS OF ACHIEVING A SINGLE PAYER SYSTEM. In the past they have proposed the public option as a trojan horse and you cannot ignore that. Just dismissing them is foolish.
When the average settlement is over $3million dollars then the $250,000 cap looks effective and fair. Once again:
The average jury award has now increased to about $3.5 million nationally, with about 57 percent of that going to attorneys’ fees. By comparison, the California Department of Insurance says the state’s malpractice insurers made a 1 percent profit between 1991 and 2000. Insurers annually pay as much as 40 percent more in claims than they receive.”
CA Tort reform has not been implemented nationwide, but it has had its benefits and so it must be implemented nationwide. CA does not exist in a bubble. In order to keep doctors in CA we have to pay them a competitive wage with the rest of the country. Medical costs from suppliers and out of state health care professionals also effects the costs of doing business.
Try what works first, then go with wild swings in the dark that appeal to our emotional sides. The rush into the abyss is foolhardy, especially in the light of our historic government spending levels and the recession. We need common sense, not Socialist pandering.
Larry W: As far as allowing wealthy over 65 to “opt out” of Medicare, why on earth would they ever want to do that, as Medicare is, quite simply put, the best health insurance plan available at virtually any cost?
There ya go… imposing your beliefs as others. I will again remind you, Larry, that the Hall v Sebelius lawsuit is *all* about what started as 3 men wanting to opt out of Medicare for a private plan, and has grown to seven. So much for “why on earth would they ever want to do that”…. obviously, they do not share your notion that Medicare is “quite simply put, the best health insurance plan available at virtually any cost”. I will also tell you I can think of at least five personal friends who were care givers for their parents who will also vehemently disagree with you.
So you’ve offered three potential solutions (above) — but I don’t see these — even collectively — making a tiny dent in the existing problems, to say nothing of the impending problems.
I have offered far more than three things in multiple comments and at least one post, Larry. As a matter of fact, the bottom of my post about the IMAC panel is entirely devoted to suggested solutions… far more than three. The IMAC, you may or may not know, is the panel of Obama appointees that get the power to decide the reimbursements/coverage for medicare based on how the budget is doing. Congress, tho they get to confirm his appointees, has only 30 days to say no way, Jose to whatever they recommend to the President via a joint resolution. This is separate legislation being written by the WH, and being carried separate from the health care bill (by Rockefeller, I believe).
Who knew that MDs were “traditionally Democrats?” I didn’t.
LOL Giving you a bit of your own back, Larry. You always base your definitive statements on your personal world and experiences. (i.e. Medicares is “simply put, the best”…) Now it could be the nature of my 19 years in liberal California, and the 9 years in very blue Oregon, but I’ve never met a conservative physician yet. Which I find quite baffling, truth be told.
But hey… I’ll remove and renege my personal comment about all the liberal physicians I know if you recant your willing suspension of disbelief that not everyone is in love with Medicare…. and may want an alternative choice.
I agree that tort reform has had benefits in CA (for providers, who have increased their take home pay), …
There ya go again…. assuming that reducing the malpractice only resulted in lining one’s own pockets instead of, perhaps, giving them the ability to continue to serve Medicare patients. It may also be that, because their overhead was lowered, they had the luxury of not opting out of handling Medicare patients, as you yourself did because of financial reimbursement and profit and loss.
So Larry… if those guys, unlike you… find it possible to continue to Medicare business because they can afford to take less in reimbursements because of their reduced E&O overhead, why do you assume they are automatically just evil and lining their own pockets? Can you prove that these doctors not only took the reduced E&O benefit, and also opted out of medicare so they could pocket more? Because the facts show that docs lose their shirts on Medicare coverage (unless they are committing fraud, of course…).
Or is this more of your own personal world experience again?
In which case, I again say… most physicians are liberals… ’cause I’ve never met a conservative one yet.
Oh and as far as Tort reform benefitting providers… that is true, so lets exam the truth behind what happened, not just leftwing rhetoric which stops there…
In the late 80s CA enacted legislation to combat this problem. The result dramatically reduced premiums and doctors were paid back the difference since MICRA was enacted. So this problem has already been addressed.
Furthermore, insurance companies were only taking advantage of a situation created by greedy lawyers and the lack of tort-reform around the country. If lawyers werent abusing our court systems for profit then insurance companies would have never had the opportunity to pocket the cash (that they were forced to pay back).
Many policymakers have called for the remodeling of Medicare to more closely resemble private insurance, which is often assumed to work better than public programs do. However, evidence from this 2001 survey demonstrates that Medicare beneficiaries are generally more satisfied with their health care than are persons under age sixty-five who are covered by private insurance. Medicare beneficiaries report fewer problems getting access to care, greater confidence about their access, and fewer instances of financial hardship as a result of medical bills. Making the program more like private insurance runs the risk of undermining a program that is working well from the perspective of beneficiaries.
Also:
Fong T Modern Healthcare (MOD HEALTHC), 2003 Jun 23; 33(25): 9
Seniors want federally run Medicare, survey says
As Congress considers privatizing parts of Medicare, a new study suggests that seniors want to keep the program under federal government control.
Seniors are skeptical of possible changes to the current program, especially increasing the role of private health plans in Medicare, according to a survey released last week by the Kaiser Family Foundation, Menlo Park, Calif.
Of seniors 65 and older, 63% said they prefer to receive their Medicare benefits through the current government-run program, while only 19% said they want to receive them through a private health plan. About 17% said they didn’t know what they preferred.
The original Bush administration plan to reform Medicare called for beneficiaries to receive prescription drug benefits only if they enrolled in a private health plan. While the administration has backed off its stand and current bills in Congress call for drug coverage within traditional Medicare, private health plans still retain a central role in the reform effort.
Regarding a prescription drug benefit, seniors in large part are satisfied with traditional Medicare, with 63% saying they prefer a drug benefit to be added to Medicare. Some 23% said they preferred the private plan model for receiving drugs, and 15% said they were unsure which they preferred.
As the administration moved away from its original plan and congressional Republicans crafted their Medicare reform bills, such sentiment clearly played a role in the design of the bills, said Drew Altman, the Kaiser foundation’s president.
“The reaction of seniors is playing a very important role in the (decision) by policymakers,” he said. “There is a blinking red light from seniors on moving Medicare to private insurers.”
nb: The above reference is a medical periodical, which I obtained through the U of California library system. It isn’t available online without a personal or institutional subscription.
I am very disappointed that you and Mike and Aye persist in your little “gotcha” game, regarding my having opted out of Medicare. Mine is a totally unique situation, which I explained in detail; in fact, my personal situation illustrates the strength of the Medicare system. This is explained in detail in comment #85, above.
You continue to make a big deal about alleged “cost shifting,” wherein doctors are losing money treating Medicare patients. This is a myth.
Show me any data at all to indicate that doctors in Texas and/or California are more likely to serve Medicare patients than doctors in states without malpractice reform. The point is that malpractice reform has had a negligible effect on health care costs, including “defensive medicine” tests in TX and CA, and there is no basis to conclude that this would/will have a notable effect on costs, were it to be extended nationally.
Well now, Larry… thank you for the respectively 6 and 7 year old data. Most notably that Health Affairs article your first linked based on a survey taken in 2001. Obviously you have not noticed that your calendar says September, 2009.
So let me bring you up to speed on what’s transpired in our Father’s Medicare, and what is proposed for Obama’s Medicare.
Every year since then, CMS has published the proposed updated cuts … including a recommended 9%+ in 2008. Every year, Congress (yes… a Republican dominated one) has beat that back. Medicare patients like their coverage the way it was, and is.
These seven men… as well as many others of us (including my parents).. do not like the writing on the wall with Obama’s vision of Medicare. And with a new twist. With Obama’s IMAC death panel – gifted with the power to usurp Congress if they can’t get a joint resolution together within 30 days – Congress has a tougher job putting a stop to those CMS cuts. Especially in light of all the whining about costs.
And to boot, Congressional members are off the hook for responsibility. They can walk back to their districts… shrugging their shoulders… and say “it was not within my power to stop it”.
IMAC… the power to destroy Medicare. Not in the health bill. Please remember that bill, Larry, as it’s stealthly running silent, running deep below sonar depth of the MSM. But then, they aren’t the brightest light bulbs.
Needless to say, your Father and Grandfather’s Medicare is not to be the Medicare of our children… hang, not even of you and me. And apparently a few of us… obviously not you… can see that Obama’s Medicare is not going to be improved, but underfunded and further undermined.
You cannot keep selling us a 1998 Mercedes as new in 2009. (Medicare of yesterday as Medicare of tomorrow). So I’d say the “fanciful” one is you, deliberately ignoring the oncoming truck because of some fantasy.
Larry: Show me any data at all to indicate that doctors in Texas and/or California are more likely to serve Medicare patients than doctors in states without malpractice reform.
Right after you show me proof that they merely lining their own pockets, including opting out of Medicare in the malpractice states. You make the assertion, I counter with another assertion. You brung it up as “fact”. I suggest you back it up.
“do not like the writing on the wall with Obama’s vision of Medicare.”
I’m not sure if you understand that the article you linked was about “Medicare Advantage,” as opposed to regular old Medicare. “Medicare Advantage” is a private Medicare plan program wherein Medicare beneficiaries can get Medicare paid coverage through private insurance companies. You can Google this and read about it. Anyway, “Medicare Advantage” costs the government more than regular Medicare; so it’s proposed to reduce funding for this program, which would increase out of pocket premiums for seniors who want to remain in it. At a time when Medicare is facing a funding crunch (because Medicare can’t raise taxes the way that private insurance can raise premiums, at will), it makes sense to cut back on a program which costs more than the regular program which most seniors depend upon.
So, is this “Obama’s vision of Medicare” — a dastardly plot cooked up by the nefarious Socialist Joker?
Not, exactly — as stated in the very article you link to expose “Obama’s vision of Medicare:”
The American Medical Association is one of several physician organizations that supports equalizing private Medicare plan pay with traditional fee-for-service pay and using the money saved to boost doctor payments. The AMA also supports the new policies in the CMS call letter.
“The AMA believes that CMS’ new oversight action will help strengthen these programs for patients,” said AMA Board of Trustees Chair Joseph M. Heyman, MD. “
We are pleased that the Obama administration listened to the concerns of physicians and implemented many of the AMA’s suggestions into its latest guidance
.”
With respect to your sarcasm about me quoting studies dating from 2001 and 2003: Of course, if there were more recent data available, I’d have quoted those. But look at what’s happened since 2003 — Medicare has only gotten better (prescription drug coverage) while private insurance has gotten worse (dramatic increase in annual premiums, increases in denials (“rationing”) for “not medically necessary” health care). There is absolutely no reason to believe that senior citizens do not continue to have greater satisfaction with Medicare than the under-65 crowd has with their private insurance plans.
Right after you show me proof that they merely lining their own pockets,–snip– You brung it up as “fact”. I suggest you back it up.
I previously provided links to news stories about (1) Texas malpractice reform not reducing costs (the language was that providers haven’t passed their malpractice premium savings down to consumers) and (2) California malpractice reform not reducing costs and unnecessary tests. If memory serves, these were two different blog “comments.”
I previously provided links to news stories about (1) Texas malpractice reform not reducing costs (the language was that providers haven’t passed their malpractice premium savings down to consumers) and (2) California malpractice reform not reducing costs and unnecessary tests.
Larry, you suggested that these savings were not passed on so that the doctors could line their own pockets. I said prove that.
Instead you just assume that selfish financial gain because of no change in the patient premiums.
What you refuse to “assume” is that these doctors were regularly running in the red, and not the black, as Medicare participants… and that instead of quitting participation (yes, as you did for financial reasons), having less over head may have lessed their annual losses, or perhaps brought them closer to break even in their business.
Until you prove to me that these guys were profitable before tort reform, and just pocketed the difference, I can’t accept your assumptions of greed. They are just speculation.
And of course it doesn’t stop unnecessary tests. The malpractice reform merely capped an amount, not prohibited lawsuits… like the French have done post 2002, when they eliminated the courts and unlimited caps from their venues. Now a government panel decides if you deserve any compensation, and it comes from a government fund.. rather like our Workman’s Comp claims. No doctors and courts involved.
And thank you for your apology. I have so many links on Obama’s vague proposed cuts which are right now, “just words”, to be determined by the IMAC panel if he gets his way. However I don’t throw Medicare C out of the mix. But can you think of a better way to drive everyone with Med Advantage out of the private world, and into the IMAC governed medicare world better than to slash their funding? As I said, it’s still money that comes from the government (save any supplementals that are not covered in any way by Medicare, and in their umbrella style coverage…). Therefore cuts affect coverage and reimbursement. And a wide power is granted to the IMAC for “recommendations” that have strict limitations on thwarting their implementation.
As you yourself say, Larry, a vast amount of retirees have supplemental medicare, or Medicare C. 40% alone in South Florida. Over 20% nationwide. So I am well aware of what Medicare Advantage is, and have posted thoroughly on Medicare A, B, C and D in some of my past posts. Your condescending attitude is not appreciated, and Medicare C insured are not immune and stand to suffer drastic changes (not for the better) in their coverage.
I might also remind you that Medicare C is still paid thru the federal government funding, but administered by private companies. It’s just johnny retiree, passing it to Uncle Sam, passing it to julie.
Further, “Medicare”… generic in it’s media descriptions, has been under cut attack even by the Bush admin… you know, that guy who didn’t try to do anything about costs? Short memory, Larry… I hear Ginko Biloba’s good. (I had a bottle… could never remember to take it… LOL)
In short, most of the proposed Medicare cuts have not happened. Obama’s cuts are vague on specifics, and long on wresting the decision power for coverage and reimbursements from Congress and the CMS and into the hands of a five member panel called the IMAC. Or, as Jack Lewin calls it, MedPAC on steroids. I did a post on it, Larry. Linked the WH proposed legislation. These five members will assess budget costs, and recommend appropriate reimbursement and coverage alterations to further cut the cost… by further cutting benefits and reimbursements. CMS and Congress? Left out in the cold.
Is the MSM reporting this? Nope. Very view, as I pointed out in my post on the IMAC health czars. Congress, always quick to want to keep their power, but apparently afraid to fight Obama on his increasing misuse of czars, seem to be pliable with this by using the alleviation of responsibility enticement. Can the IMAC be stopped?
With respect to your sarcasm about me quoting studies dating from 2001 and 2003: Of course, if there were more recent data available, I�d have quoted those.
Well now, were it all incense, peppermint and roses, I’m sure studies galore would have arisen to support a New Age medicare for the under 65, don’t you think? Medicare D is the major improvement for consumers, but also a major cost to the nation’s budget. Better? Depends on from where you stand. If you’re the one getting the drugs at a deep discount, yup. But then, the further spiral into debt for these programs is taking it’s toll on the economy.
The reason I again have to call you on your data is because you are constantly comparing Medicare yesterday to O’Medicare tomorrow as proposed. From some reason, you just can’t grasp the proposed changes. Or perhaps you just can’t put the puzzle together. You think it will be improved, when it will be dissected. And you don’t even give a whit that the dissection will be an unConstitutional move of Congressional power…. make that yet *another* unConstitutional move of Congressional power…. 36 czars later….
Medicare hasn’t “gotten better”. What it’s done with withstand assault from being sliced and diced. And now that’s no longer going to happen.
And I don’t appreciate your snippy comments about the “socialist joker”. I’ve never made one comment on that poster, created by a Democrat. Why you would bring up such horse manure to me is unconcionable, since I don’t fight my debates that way. Shame on you.
“obama joker” was a reference to FA in general. I was addressing the same “wider” audience as you. If you’d ever like to have a private conversation/debate via private email, I do this regularly, with friends both to the Left and Right of me. We can both be less theatrical, in this setting. Same goes for anyone else who wants to write: runnswim@aol.com
In #134, I was addressing your “Obama’s vision for Medicare” link in your #132. This wasn’t about his vision for Medicare; it was about his vision for Medicare Advantage. Furthermore, it wasn’t Obama’s vision. It was the AMA’s vision. I was simply pointing this out — again, to the same “wider” audience. I’m sorry if I denigrated your knowledge of Medicare law. From the “Obama’s vision for Medicare” link you chose to cite, it appeared that there were gaps in your understanding. I stand corrected.
With regard to the obvious fact that ALL insurance coverage is going to have to undergo changes, whether Medicare or private sector, as medical costs continue to explode, the most important fact is that, in the public sector, all proposed changes will be thoroughly and transparently vetted (unlike in the private insurance sector). Neither George W Bush (as you pointed out) nor Barack H Obama has the power to impose his will on the process. I’ve got more trust in the system of checks and balances than you have. A President can wage war, virtually on his own, as proven again and again, but he can’t do much else important on his own, particularly as relates to health care.
@Mike
Easy, big guy..I was the one who wrongly called him a liar. (lier…stupid spellchecker ;-))
@Larry
1. In my haste to read your post, I failed to note that you pay for more than your immediate family, and that you pay for extra coverage. I apologize for this, and will strive to be more careful next time (No scanning!), and keep my emotions in check, regardless.
Again, my bad.
2.Thank you very much for the offer of consultation. I know your time is your money, and the offer means a lot. In light of #1, it is a very gracious offer.
3. 59.03 sec 100m Fly in Dec of 78. Top that! (Oh g-d that was a long time ago! 🙂
Now back to the joust…
Do you think if Obamacare passes you will be able to keep that coverage (Congress calls it “Cadillac-care”) without being taxed to bejeezus for it?
According to my policy, Kaiser will cover equipment they don’t have (But I’m sure they will soon enough) at 80%. I also don’t ever see using up a mil out of network. 99.99% of the time, out of network usually means an emergency-room somewhere, where I have no choice in where the ambulance takes me.
Medicare is broke, Medicare can cross State lines, I have no problems with their service, I have a problem with it’s fiscal management, and the fact that private plans have a different set of rules. (Kaiser is also non-profit, but you probably know that.)
Look over the lists I’ve made in the other thread. I could fix this mess in one page. The REAL problem I have with this Bill is that it has NOTHING to do with “fixing” how healthcare gets paid for… I wonder how much you pay each year to keep the Tort-trolls away from your checkbook?
It’s all about power for the Democrats, period, and I stand by my previous posits.
@Patvann: Holy s—; 59:03 LCM in ’78 (pre-bodysuit). I couldn’t carry your goggles.
@mike: whatever (is that sufficiently succinct?)
– Larry W/HB
I wonder what the AMA is getting out of the deal. Another closed door negotiation like Big Pharma got?
Transparency? B.S.
I stand strongly with PatVann:
Larry, when it comes to medicine, no question, you are the “gifted gold standard.” Why or how someone as brilliant as you are is not the least bit concerned about the ‘corrupt thugs ‘who will be overseeing “healthcare reform”, is a total enigma. This is far bigger than perscription drug or even Medicare; 1/6 of the entire economy to be exact.
Most of all, it is UNDOABLE; at least in our lifetimes. What are the chances that after half the country is either employed, compensated, or benefited other ways by “Obamcare”, anyone is going to vote anything other than democrat? They, in all of their corruption, will OWN us for the rest of our lives. Consequently, we will have to live with tax payer funded abortions, and life or death decisions, regulated by HHS, i.e, currently Kathleen Sebelius, who’s election btw was funded by “Tiller the Baby Killer.”
Do you ever stop and think about the people BEHIND the scenes, the real decision makers? Do you really believe, based on 9 months of Obama telling us one thing and doing another, that the people behind this can be trusted? I know you hate it when I agree with Palin on the “death panels”, but does it not bother you that the language she was referring to was written by a euthanasia supporting congressman from Oregon, only recently discovered? Does it not bother you that, unlike what they want us to believe, abortions WILL be paid for by tax payers?
And all of that is just for starters. The halllmark of this administration is the relegation of human life. You more than anyone on this blog understand the places biotech is going; when no man has gone, and with no regulations. Watch for the Dickey Wicker amendment to be overturned next ,after “health care passes of course”, and all bets are off on “human experimentation.” Before your first grandkid is born we will have “fetal farms” where ’embryos’
are grown for ‘spare parts’. Not long ago, I referenced an article out of the ‘esteemed NEJM’, the medical journal you agree as being the cream of the crop. Here’s an excerpt:
Why would the NEJM run such an “opinion piece” if what I’m claiming is “scare mongering?”
Are you totally unaware how much of a ‘behind the scenes effort’ is being made to “reduce population?” Of course, it never makes MSM. Just follow “the big money” on population control.
Gosh, even “swine flu” creeps me out. Is it just me, or is there just a little too much “hype and certainty”that just may contribute to the death, or dare I say, sterilization, of many of us?
And how about the elderly? They more than anyone have paid all of their lives into Medicare, only to come into their sunset years and be given the Obamcare line that “A 25 year old has much more worth than you, consequently, your hip repleacment, or heart sugery, simply isn’t ‘economical’. I agree that currently, Medicare is a good thing. But to think it is going to “stay as is or improve” is a pipe dream; not under these thugs.
I could go on endlessly, pointing out why the “people in front and behind the curtain” are not to be trusted. PatVann is right. It is ALL ABOUT POWER. And what is more of a “power statment” than who controls human life, from conception (embryo), to ‘natural death’?
We don’t and never had a “population” problem. Resources are more plentiful than ever, and even if they weren’t, who are any of us to decide for our Creator. Our only problem is a morality problem, from which all others follow. Under the Obama adminsitration, “healthcare” will not only be the death of many of us, it will be the death of America .
Like most Americans, I’m totally for health care reform, but not at the expense of human life, which, ironically, is what “Obamacare” AND POWER, is all about,
@Aye (#103): Can you provide a link? There’s a lot in that which is just plain wrong, but I’d like to read and seriously consider it, before responding. – Larry W/HB
@pat:
Can you provide a link for the above quote?
– LW/HB
@openid.aol.com/runnswim:
The link is embedded in the bolded red first line of my comment.
Just click on it.
@aye: thanks.
It’s a questionnaire — not a scientific survey; how do I know this?
“Responses are still coming in.”
Some factual errors:
It wasn’t a “National Public Radio” poll. It was a scientific survey, with methodology passing stringent statistical peer review, conducted by the Mayo Clinic and the University of Chicago, and published in the New England Journal of Medicine.
The LA Times story was centrally about the Mayo/Chicago study (I provided a link to the full text of this study). As part of the story, it included related background information about the official position of organized medicine, through the AMA.
I think that the AMA membership is about 30% of America’s doctors. There is a lot of internal dispute: it’s chiefly a battle over the “pie.” Right now, procedures get reimbursed generously (i.e. surgeons, interventional radiologists, and the like), while primary care is reimbursed poorly. There is a nationwide shortage of primary care doctors and a surplus of surgical specialists. So health care reform (which includes Medicare reform) calls for “redistributing” (through changing reimbursement formulas) reimbursement from procedures to primary care medicine. Of course, this puts the primary care doctors on board and puts the surgeons on the other side. One can’t possibly evaluate the Investors Business Daily poll without detailed information as to percentage of respondents which were in each type of medical specialty and how these percentages stack up against national figures. These data were provided in detail in the Mayo Clinic/U of Chicago study, but not in the Investors Business Daily poll.
This is utterly ridiculous and has no credibility whatsoever.
This is utterly ridiculous and has no credibility whatsoever. You’ve got people who have invested a dozen or more years in post-high school education and they are going to bail because their incomes might possibly drop from $300K to $200K? And, as I noted above, the doctors who’s incomes might drop most are those who are in oversupply and the doctors who’s incomes are likely to rise are the doctors in the shortest supply.
>>Hope for a surge in new doctors may be misplaced. A recent study from the Association of American Medical Colleges found steadily declining enrollment in medical schools since 1980.<<
This makes it sound as if people are reluctant to go into medicine. Not true. This is because medical schools nationwide reduced enrollment by 20-33% in the early 80s because of fears of a "doctor glut." Med school admissions have never been more competitive than they are today.
http://www.aamc.org/data/facts/2008/2008school.htm
n.b. Compare "applications" (number of people applying) with "Matriculants" (number of applicants accepted and enrolled)
Here in California, a single "B" in organic chemistry is viewed as a death knell for successful admission by pre-meds.
I can't comment further until I can actually see the actual details of the poll methodology. But the article itself is obviously written with a strong point of view.
PDill's message is more about abortion and anti-Obama sentiment than about health care reform, per se. How do I respond to "Obama is evil?" I am supposed to say "No, he isn't?" So it wouldn't be a productive discussion.
– Larry Weisenthal/Huntington Beach, CA
@Aye: my reply to #103 went to spam. – LW
Larry, I wish you would focus more on the “overall big picture” of the types of people running the show, instead of trying to defend your POV by whitewashing soundbites and symantics.
For the life of me I can’t fathom how you don’t “get” these guys, especially considering your expertise in medicine and reputation for ethics and good character. PLEASE Larry, at least in this most critical crossroad of American politics, dare to go where liberals just never seem to go, and look at the BIG PICTURE.
You may be a bleeding heart liberal, but you are not a radical, and that’s who’s calling the shots here, LEFT WING RADICALS! Maybe you need to spend some time reading the writings of people like Holdern, Zeak Emauel, Cass Sunstein, Peter Singer, and of course, the “non accountable” czars.
Here’s the link (one of many) with an excerpt:
@PDill:
Dr. Emmanuel can have whatever personal views he wants; he doesn’t run the country. He doesn’t have any power at all over Medicare.
The GOP was in control of the country for 6 years. I give George W Bush credit for wanting to do something about health care, but his own party wouldn’t go along with him.
We truly do have an unsustainable health care mess in this country. It’s a global problem, caused mainly by technology explosions. But, of all the Western nations, we’ve got the greatest problems. Private insurance funded health care is actually leading the public sector with respect to “rationing,” as I’ve repeatedly tried to illustrate.
You are so worried about government “death panels;” well, that’s never going to happen, because we do have a Constitution and it doesn’t include a dictator. But private insurance companies have their own dictators and no one can do anything about them. And health care is immune from the economic principles which control corporate behavior and the behavior of salespeople in the sectors of the capitalist economy which do, indeed, work extremely well.
So you are willing to let the current rotting system continue to rot ad infinitum because Obama is evil and he’s surrounded by evil people and they are going to do evil things to us?
I can’t respond to thinking like that.
– Larry
@Larry
RE:107
@pat:
given the Obamcare line that “A 25 year old has much more worth than you, consequently, your hip repleacment, or heart sugery, simply isn’t ‘economical’.
Can you provide a link for the above quote?
I am afraid that was not one of my comments.
My first response to it though, is that that line is NOT in any Bill, but is one of the theories explored by Obama’s Science Advisor in a book he published a while back.
If you like, I will find the actual quote, in its complete context.
@Larry
Found it…
The full quote is by Ezekiel Emanuel:
Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-yearolds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.
It is from a report in The Lancet, earlier this year:
Here
You may also find this quote by him interesting (from Hastings)
This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.
And can be found
here
The biggest problem that our healthcare system has is that it is expensive. Tort reform is the obvious answer.
Not creating a godzilla-like socialist health care option that would offer free healthcare. How are private insurance companies supposed to compete with such a well-funded and well-connected entity that offers the same product for free?
As past statements by Obama, Frank and many other Democratic Party politicians reveals… the public option method is the best way to achieve a single payer healthcare system. All this mambo jumbo about increasing competition is nothing but a lie.
Enough b.s. already…
@Freedom Now
We’ve had tort reform in California for 30 years. Cap of $250,000 on pain and suffering. No punitive damages. You can’t really do more than that. You have to compensate people for actual damages (medical expenses and lost wages) secondary to negligence. They’ve also had tort reform in Texas for several years, modeled after California’s. There is no evidence at all that this has reduced ordering of unnecessary tests for defensive medicine or saved the health care system any money.
Below is a very excellent article, which should provoke some thought.
About 1/3 of all Americans will get cancer. Of these, about 25% will exhaust their savings or nearly exhaust their savings in treating the disease.
“Even among families with health insurance, 33% of the respondents” (in a Kaiser Foundation and Harvard School of Public Health study) “said they struggled to pay medical bills.”
Another interesting statistic: “Medicare spends one-third the total cost of treating cancer in the final year of life and 78% of that spending occurs in the final month.”
http://www.hemonctoday.com/article.aspx?rid=43593
I’m not sure what the answer is, but it’s neither the status quo nor “malpractice reform.” I do know that’s it’s a real shame that we are wasting so much energy on screaming about red herrings like “single payer” (ain’t gonna happen, no way. Where we are headed is continental Europe and not Canada nor the UK). And “rationing” (already going on, and mostly in the private sector). And “death panels.”
– Larry Weisenthal/Huntington Beach, CA
CA is a bad example for your argument Larry. It actually proves the opposite of what you assert.
First off, the reform in CA has been demonstrated to save a lot of money (Texas still has reform problems).
Secondly, California is one of the only 5 states that the AMA deems to be OK as far as tort reform goes.
From 1986 to 2000, premiums fell 12 percent in California, while rising 55 percent nationally (in inflation-adjusted dollars). During that same period, rates in Florida rose 809 percent; in Nevada 8,375 percent.
Trial lawyers have been fighting this for years. Lets make CA’s MICRA national and put the brakes on medical malpractice abuse which causes the defensive medicine that helps make health expensive.
“In California two years ago, an OB/GYN paid on average $47,500 for malpractice insurance. In Florida, she paid $173,000. Neurosurgeons paid $68,436 in Los Angeles County, but $278,829 in Dade County, Fla., and $163,000 in suburban Detroit and New York. In California, an orthopedic surgeon paid $22,730, but in Pennsylvania $90,297.”
http://www.calphys.org/html/bb193.asp
The average jury award has now increased to about $3.5 million nationally, with about 57 percent of that going to attorneys’ fees. By comparison, the California Department of Insurance says the state’s malpractice insurers made a 1 percent profit between 1991 and 2000. Insurers annually pay as much as 40 percent more in claims than they receive.”
http://www.thedoctors.com/ecm/groups/public/@tdc/@web/documents/reprint/con_id_001167.pdf
I’m glad that you are so confident that we are not headed for a single payer system even though our top leaders have expressed their desire to use the introduction of a public option as a means to single payer.
You must have a lot of confidence that the Tea Party movement will prevent the Democratic Party leadership from realizing their cherished goal of a single payer healthcare system. Good for you…
@Freedom now: My point was that CA malpractice reform neither reduced ordering of “defensive” tests nor had any demonstrable effect on lowering health care costs or increasing health insurance affordability (I previously gave a link for this). What it did was to allow providers to make more money, which is useful in CA, where real estate and cost of living in areas where doctors tend to live is pretty high.
Here’s what I was responding to, your statement that:
I’ve stated several times that I’m totally on board with the concept of CA-style being a good thing, but the idea that malpractice reform is the solution to “the biggest problem” in our healthcare system is fanciful.
-Larry Weisenthal/Huntington Beach, CA
Boyo… feel like I get to poke my head in the party door for a minute, catch up, make a comment and gone. Sorry can’t stay more in depth, of late. But Mr. Larry…
Now Larry, this not only isn’t based on any fact, it’s pretty unflattering an attitude you have there. First of all, the only fact we do know about the malpractice reform is that is brings down a physician’s E&O insurance. You happen to translate that as allowing them to engage in fat cat lifestyles.
So allow me to pose an alternative for you. I could also make the claim that many of these doctors were so underwater financially from the high E&O, plus taking Medicare patients and low reimbursements, that this savings on their E&O allowed them to continue to take Medicare patients… or even stay in business.
I’d say my view of a doctor’s savings on his operating expenses is just as based in fact as yours… perhaps more since you, yourself, know that doctors either opt out of Medicare for financial reasons, and that E&O costs an arm and a leg. Your view, on the other hand, is just kind of a weird judgmental aspersion…. Which becomes even more hilarious with you think that the majority of the medical professional is traditionally Democrat, and not those evil rich corporate Republicans.
I think most of us realize there is no one magic bullet. However when you combine the savings of malpractice tort reform, “hope” for control on Medicare fraud, allow wealthy over 65 seniors to opt out of Medicare without penalty, etc etc…. none of which costs the taxpayers a dime…. we might see some results. It will take many things.. and none of them need include a public option.. nor a mandate that employers provide insurance or pay fines.
There is no need to reinvent the wheel here… which is “da plan”.
@mata: What I said was that CA and Texas reduced malpractice premiums, with no evidence at all that they reduced defensive medicine or overall health care costs. I’m sure that it did have marginal effects. I agree that malpractice reform is a good idea, but it’s at most a drop in the bucket
As far as allowing wealthy over 65 to “opt out” of Medicare, why on earth would they ever want to do that, as Medicare is, quite simply put, the best health insurance plan available at virtually any cost? With regard to Medicare “fraud,” this is a health system-wide problem and not simply a Medicare problem. The GOP controlled government for 6 years and never began to make a serious effort to solve any of the health care problems, just as they made no serious effort to solve energy problems (this latter is not my criticism, but is a criticism expressed by my own very conservative GOP congressman, Dana Rohrabacher, in one of his frequent “town meetings” by telephone, in which I participated).
So you’ve offered three potential solutions (above) — but I don’t see these — even collectively — making a tiny dent in the existing problems, to say nothing of the impending problems.
– Larry Weisenthal/Huntington Beach, CA
P.S. Who knew that MDs were “traditionally Democrats?” I didn’t. It is true that MDs have grown less conservative over the years, chiefly as a result of increasing number of women entering the field. In my own personal experience, female doctors tend to be less conservative than male doctors. This is going to keep increasing, by the way. When my sister was a medical student, there were 8 women and 200 men in her class. With me it was something like 28 women and 190 men. Today, at the same medical school (the U of Michigan) the majority of the entering classes are women. It’s a huge demographic shift. Women tend to be less likely than men to enter medicine for the promise of hefty financial rewards. Certainly that’s the case with my own female doctor-to-be offspring.
@openid.aol.com/runnswim: “In my own personal experience, female doctors tend to be less conservative than male doctors.”
Just the opposite in my experience. My cousin is an E.R. Pediatrician and isn’t exactly a liberal.
Also, the OB-GYN’s I knew who were female were quite conservative.
@Mike: I was best man at a wedding of two doctors. Gal lots more liberal than guy. But it’s all just anecdotal chit chat. In my spare time, I’ll try to find some survey/study. Are the pediatrician/OG GYNs you quote South Carolina residents? I’d imagine that they’d trend more conservative than those in CA.
By the way, your comment (somewhere else) about one of Nate Silver’s criticisms of the IDB/TIPP survey was on target. All (or virtually all) surveys of doctor’s opinions are in the form of written questionnaires, typically including a small honorarium. I’ve filled out several Robert Wood Johnson -sponsored surveys myself. They are typically quite detailed, including lots of questions which don’t make it into the published surveys, presumably to in some way provide some quality control regarding responses. I can’t imagine any doctor who’d be willing to answer phone questions from a stranger about medically related political opinions.
– Larry Weisenthal/Huntington Beach, CA
@openid.aol.com/runnswim: I grew up in Ohio surrounded by my father’s OB GYN colleagues. And my cousin works in Ann Arbor, Michigan, a bastion of liberalism.
So Nate didn’t jump all over the Robert Wood Johnson mail in survey? GOLLLLEEEE! I am SOOOO suprised!
Larry,
Will you remain paralized with indecision? What kind of reform do you suggest, if you suggest none?
What you are trying to do is blow smoke to deflect away from something that did work. Tort-reform has dramatically lowered premiums for medical professionals in CA (save the propaganda, you admit that this aspect of reform worked, but cite the above reason to IGNORE IT).
Most of the rest of the country does not have effective tort-reform. Do you suggest witholding a model of reform that has worked?
@freedom (#125)
I agree that tort reform has had benefits in CA (for providers, who have increased their take home pay), but this has not reduced the ordering of defensive tests nor lowered health care costs for businesses or individuals. OF COURSE IT IS WORTH DOING (I AGREE with you on that), but it’s really a side issue. I think that you (or someone else) claimed that malpractice reform was supposed to be a big part of the solution to reducing health care costs. This is certainly the current GOP party line, among those who are asked, well, if you are against Obama’s plan, then what is YOUR solution?
The answer is that it’s been tried, in California, which is 10% of the nation’s population, and also in Texas, another big state. In neither case did it make a dent in costs to the health care consumer or reduce the ordering of defensive medicine tests. The latter should come as no surprise — malpractice awards are plenty high without there being punitive damages and pain and suffering awards — there is more than enough incentive, even in the presence of malpractice reform, to continue to practice defensive medicine.
– Larry Weisenthal/Huntington Beach, CA
Do you or do you not support the Public Option?
Name something substantial in Obama’s plan that has been demonstrated to reduce medical costs and be honest, giving free healthcare costs to individuals comes with (not so) hidden costs. Therefore, businesses and individuals still pay for Socialized medicine (even limited Socialized medicine like the public option). It is a huge financial burden on the government, which must be supported by taxpayers and leads to a lower quality of healthcare.
So whats next, free housing? Housing is a problem too.
History has proven that ‘Bread and Circus’ does not work as a longterm solution. Furthermore, YOU HAVE NOT EVEN ADDRESSED THE FACT THAT OUR LEADING DEMOCRATS HAVE PROPOSED MANY TIMES IN THE PAST TO INTRODUCE THE PUBLIC OPTION AS A MEANS OF ACHIEVING A SINGLE PAYER SYSTEM. In the past they have proposed the public option as a trojan horse and you cannot ignore that. Just dismissing them is foolish.
When the average settlement is over $3million dollars then the $250,000 cap looks effective and fair. Once again:
The average jury award has now increased to about $3.5 million nationally, with about 57 percent of that going to attorneys’ fees. By comparison, the California Department of Insurance says the state’s malpractice insurers made a 1 percent profit between 1991 and 2000. Insurers annually pay as much as 40 percent more in claims than they receive.”
CA Tort reform has not been implemented nationwide, but it has had its benefits and so it must be implemented nationwide. CA does not exist in a bubble. In order to keep doctors in CA we have to pay them a competitive wage with the rest of the country. Medical costs from suppliers and out of state health care professionals also effects the costs of doing business.
Try what works first, then go with wild swings in the dark that appeal to our emotional sides. The rush into the abyss is foolhardy, especially in the light of our historic government spending levels and the recession. We need common sense, not Socialist pandering.
There ya go… imposing your beliefs as others. I will again remind you, Larry, that the Hall v Sebelius lawsuit is *all* about what started as 3 men wanting to opt out of Medicare for a private plan, and has grown to seven. So much for “why on earth would they ever want to do that”…. obviously, they do not share your notion that Medicare is “quite simply put, the best health insurance plan available at virtually any cost”. I will also tell you I can think of at least five personal friends who were care givers for their parents who will also vehemently disagree with you.
I have offered far more than three things in multiple comments and at least one post, Larry. As a matter of fact, the bottom of my post about the IMAC panel is entirely devoted to suggested solutions… far more than three. The IMAC, you may or may not know, is the panel of Obama appointees that get the power to decide the reimbursements/coverage for medicare based on how the budget is doing. Congress, tho they get to confirm his appointees, has only 30 days to say no way, Jose to whatever they recommend to the President via a joint resolution. This is separate legislation being written by the WH, and being carried separate from the health care bill (by Rockefeller, I believe).
LOL Giving you a bit of your own back, Larry. You always base your definitive statements on your personal world and experiences. (i.e. Medicares is “simply put, the best”…) Now it could be the nature of my 19 years in liberal California, and the 9 years in very blue Oregon, but I’ve never met a conservative physician yet. Which I find quite baffling, truth be told.
But hey… I’ll remove and renege my personal comment about all the liberal physicians I know if you recant your willing suspension of disbelief that not everyone is in love with Medicare…. and may want an alternative choice.
There ya go again…. assuming that reducing the malpractice only resulted in lining one’s own pockets instead of, perhaps, giving them the ability to continue to serve Medicare patients. It may also be that, because their overhead was lowered, they had the luxury of not opting out of handling Medicare patients, as you yourself did because of financial reimbursement and profit and loss.
So Larry… if those guys, unlike you… find it possible to continue to Medicare business because they can afford to take less in reimbursements because of their reduced E&O overhead, why do you assume they are automatically just evil and lining their own pockets? Can you prove that these doctors not only took the reduced E&O benefit, and also opted out of medicare so they could pocket more? Because the facts show that docs lose their shirts on Medicare coverage (unless they are committing fraud, of course…).
Or is this more of your own personal world experience again?
In which case, I again say… most physicians are liberals… ’cause I’ve never met a conservative one yet.
sorry, I used the term “settlement” when I should have used “jury award”.
Oh and as far as Tort reform benefitting providers… that is true, so lets exam the truth behind what happened, not just leftwing rhetoric which stops there…
In the late 80s CA enacted legislation to combat this problem. The result dramatically reduced premiums and doctors were paid back the difference since MICRA was enacted. So this problem has already been addressed.
Furthermore, insurance companies were only taking advantage of a situation created by greedy lawyers and the lack of tort-reform around the country. If lawyers werent abusing our court systems for profit then insurance companies would have never had the opportunity to pocket the cash (that they were forced to pay back).
@mata (#128)
It is utterly fanciful to believe that more than a very small percentage of people would choose to replace Medicare with a private insurance plan.
http://content.healthaffairs.org/cgi/reprint/hlthaff.w2.311v1
Also:
Fong T Modern Healthcare (MOD HEALTHC), 2003 Jun 23; 33(25): 9
nb: The above reference is a medical periodical, which I obtained through the U of California library system. It isn’t available online without a personal or institutional subscription.
I am very disappointed that you and Mike and Aye persist in your little “gotcha” game, regarding my having opted out of Medicare. Mine is a totally unique situation, which I explained in detail; in fact, my personal situation illustrates the strength of the Medicare system. This is explained in detail in comment #85, above.
You continue to make a big deal about alleged “cost shifting,” wherein doctors are losing money treating Medicare patients. This is a myth.
http://www.thehealthcareblog.com/the_health_care_blog/2009/08/the-health-care-cost-shifting-myth.html
Show me any data at all to indicate that doctors in Texas and/or California are more likely to serve Medicare patients than doctors in states without malpractice reform. The point is that malpractice reform has had a negligible effect on health care costs, including “defensive medicine” tests in TX and CA, and there is no basis to conclude that this would/will have a notable effect on costs, were it to be extended nationally.
– Larry Weisenthal/Huntington Beach, CA
Well now, Larry… thank you for the respectively 6 and 7 year old data. Most notably that Health Affairs article your first linked based on a survey taken in 2001. Obviously you have not noticed that your calendar says September, 2009.
So let me bring you up to speed on what’s transpired in our Father’s Medicare, and what is proposed for Obama’s Medicare.
Every year since then, CMS has published the proposed updated cuts … including a recommended 9%+ in 2008. Every year, Congress (yes… a Republican dominated one) has beat that back. Medicare patients like their coverage the way it was, and is.
These seven men… as well as many others of us (including my parents).. do not like the writing on the wall with Obama’s vision of Medicare. And with a new twist. With Obama’s IMAC death panel – gifted with the power to usurp Congress if they can’t get a joint resolution together within 30 days – Congress has a tougher job putting a stop to those CMS cuts. Especially in light of all the whining about costs.
And to boot, Congressional members are off the hook for responsibility. They can walk back to their districts… shrugging their shoulders… and say “it was not within my power to stop it”.
IMAC… the power to destroy Medicare. Not in the health bill. Please remember that bill, Larry, as it’s stealthly running silent, running deep below sonar depth of the MSM. But then, they aren’t the brightest light bulbs.
Needless to say, your Father and Grandfather’s Medicare is not to be the Medicare of our children… hang, not even of you and me. And apparently a few of us… obviously not you… can see that Obama’s Medicare is not going to be improved, but underfunded and further undermined.
You cannot keep selling us a 1998 Mercedes as new in 2009. (Medicare of yesterday as Medicare of tomorrow). So I’d say the “fanciful” one is you, deliberately ignoring the oncoming truck because of some fantasy.
Right after you show me proof that they merely lining their own pockets, including opting out of Medicare in the malpractice states. You make the assertion, I counter with another assertion. You brung it up as “fact”. I suggest you back it up.
@Mata
Regarding the fact that some
“do not like the writing on the wall with Obama’s vision of Medicare.”
I’m not sure if you understand that the article you linked was about “Medicare Advantage,” as opposed to regular old Medicare. “Medicare Advantage” is a private Medicare plan program wherein Medicare beneficiaries can get Medicare paid coverage through private insurance companies. You can Google this and read about it. Anyway, “Medicare Advantage” costs the government more than regular Medicare; so it’s proposed to reduce funding for this program, which would increase out of pocket premiums for seniors who want to remain in it. At a time when Medicare is facing a funding crunch (because Medicare can’t raise taxes the way that private insurance can raise premiums, at will), it makes sense to cut back on a program which costs more than the regular program which most seniors depend upon.
So, is this “Obama’s vision of Medicare” — a dastardly plot cooked up by the nefarious Socialist Joker?
Not, exactly — as stated in the very article you link to expose “Obama’s vision of Medicare:”
With respect to your sarcasm about me quoting studies dating from 2001 and 2003: Of course, if there were more recent data available, I’d have quoted those. But look at what’s happened since 2003 — Medicare has only gotten better (prescription drug coverage) while private insurance has gotten worse (dramatic increase in annual premiums, increases in denials (“rationing”) for “not medically necessary” health care). There is absolutely no reason to believe that senior citizens do not continue to have greater satisfaction with Medicare than the under-65 crowd has with their private insurance plans.
– Larry Weisenthal/Huntington Beach, CA
I previously provided links to news stories about (1) Texas malpractice reform not reducing costs (the language was that providers haven’t passed their malpractice premium savings down to consumers) and (2) California malpractice reform not reducing costs and unnecessary tests. If memory serves, these were two different blog “comments.”
– Larry Weisenthal/Huntington Beach, CA
Larry, you suggested that these savings were not passed on so that the doctors could line their own pockets. I said prove that.
Instead you just assume that selfish financial gain because of no change in the patient premiums.
What you refuse to “assume” is that these doctors were regularly running in the red, and not the black, as Medicare participants… and that instead of quitting participation (yes, as you did for financial reasons), having less over head may have lessed their annual losses, or perhaps brought them closer to break even in their business.
Until you prove to me that these guys were profitable before tort reform, and just pocketed the difference, I can’t accept your assumptions of greed. They are just speculation.
And of course it doesn’t stop unnecessary tests. The malpractice reform merely capped an amount, not prohibited lawsuits… like the French have done post 2002, when they eliminated the courts and unlimited caps from their venues. Now a government panel decides if you deserve any compensation, and it comes from a government fund.. rather like our Workman’s Comp claims. No doctors and courts involved.
And thank you for your apology. I have so many links on Obama’s vague proposed cuts which are right now, “just words”, to be determined by the IMAC panel if he gets his way. However I don’t throw Medicare C out of the mix. But can you think of a better way to drive everyone with Med Advantage out of the private world, and into the IMAC governed medicare world better than to slash their funding? As I said, it’s still money that comes from the government (save any supplementals that are not covered in any way by Medicare, and in their umbrella style coverage…). Therefore cuts affect coverage and reimbursement. And a wide power is granted to the IMAC for “recommendations” that have strict limitations on thwarting their implementation.
As you yourself say, Larry, a vast amount of retirees have supplemental medicare, or Medicare C. 40% alone in South Florida. Over 20% nationwide. So I am well aware of what Medicare Advantage is, and have posted thoroughly on Medicare A, B, C and D in some of my past posts. Your condescending attitude is not appreciated, and Medicare C insured are not immune and stand to suffer drastic changes (not for the better) in their coverage.
I might also remind you that Medicare C is still paid thru the federal government funding, but administered by private companies. It’s just johnny retiree, passing it to Uncle Sam, passing it to julie.
Further, “Medicare”… generic in it’s media descriptions, has been under cut attack even by the Bush admin… you know, that guy who didn’t try to do anything about costs? Short memory, Larry… I hear Ginko Biloba’s good. (I had a bottle… could never remember to take it… LOL)
Medicare proposed cuts in 2002
NYTs Sept 22nd article, 2002
Daschle letter Nov 2002 on IDSA site
2003: ACC Advocacy fights Medicare cuts
Proposed cuts as noted by the center on Budget and Policy Priorities That was a $214 bil over 10 years cut in Medicare. A drop in the bucket compared to O’Medicare.
In 2004, even Greenspan was jumping on the “cut Medicare” bandwagon, right along with Social Security. Radio broadcast
The American College of Emergency Physicians talks about the of 5% payment reduction for 2007 unless Congress intervenes.
On the flip side, Congress approved a 1.1% increase in physician payments in 2008.
In short, most of the proposed Medicare cuts have not happened. Obama’s cuts are vague on specifics, and long on wresting the decision power for coverage and reimbursements from Congress and the CMS and into the hands of a five member panel called the IMAC. Or, as Jack Lewin calls it, MedPAC on steroids. I did a post on it, Larry. Linked the WH proposed legislation. These five members will assess budget costs, and recommend appropriate reimbursement and coverage alterations to further cut the cost… by further cutting benefits and reimbursements. CMS and Congress? Left out in the cold.
Is the MSM reporting this? Nope. Very view, as I pointed out in my post on the IMAC health czars. Congress, always quick to want to keep their power, but apparently afraid to fight Obama on his increasing misuse of czars, seem to be pliable with this by using the alleviation of responsibility enticement. Can the IMAC be stopped?
Well now, were it all incense, peppermint and roses, I’m sure studies galore would have arisen to support a New Age medicare for the under 65, don’t you think? Medicare D is the major improvement for consumers, but also a major cost to the nation’s budget. Better? Depends on from where you stand. If you’re the one getting the drugs at a deep discount, yup. But then, the further spiral into debt for these programs is taking it’s toll on the economy.
The reason I again have to call you on your data is because you are constantly comparing Medicare yesterday to O’Medicare tomorrow as proposed. From some reason, you just can’t grasp the proposed changes. Or perhaps you just can’t put the puzzle together. You think it will be improved, when it will be dissected. And you don’t even give a whit that the dissection will be an unConstitutional move of Congressional power…. make that yet *another* unConstitutional move of Congressional power…. 36 czars later….
Medicare hasn’t “gotten better”. What it’s done with withstand assault from being sliced and diced. And now that’s no longer going to happen.
And I don’t appreciate your snippy comments about the “socialist joker”. I’ve never made one comment on that poster, created by a Democrat. Why you would bring up such horse manure to me is unconcionable, since I don’t fight my debates that way. Shame on you.
@mata:
“obama joker” was a reference to FA in general. I was addressing the same “wider” audience as you. If you’d ever like to have a private conversation/debate via private email, I do this regularly, with friends both to the Left and Right of me. We can both be less theatrical, in this setting. Same goes for anyone else who wants to write: runnswim@aol.com
In #134, I was addressing your “Obama’s vision for Medicare” link in your #132. This wasn’t about his vision for Medicare; it was about his vision for Medicare Advantage. Furthermore, it wasn’t Obama’s vision. It was the AMA’s vision. I was simply pointing this out — again, to the same “wider” audience. I’m sorry if I denigrated your knowledge of Medicare law. From the “Obama’s vision for Medicare” link you chose to cite, it appeared that there were gaps in your understanding. I stand corrected.
With regard to the obvious fact that ALL insurance coverage is going to have to undergo changes, whether Medicare or private sector, as medical costs continue to explode, the most important fact is that, in the public sector, all proposed changes will be thoroughly and transparently vetted (unlike in the private insurance sector). Neither George W Bush (as you pointed out) nor Barack H Obama has the power to impose his will on the process. I’ve got more trust in the system of checks and balances than you have. A President can wage war, virtually on his own, as proven again and again, but he can’t do much else important on his own, particularly as relates to health care.
– Larry Weisenthal/Huntington Beach, CA