With all the excitement over Obama's various domestic proposals (health care, Cap & Trade etc.), it is easy to forget the realm of international relations. Obama's policy of apologies (for the actions of others) and appeasement have so far proven to be a dismal failure. To make matters worse, Obama now seems to be intent to blame Israel for his failures (more convenient than Republicans I suppose).
Check out this piece "The rigged game" by Caroline Glick.
From Glick's op/ed:
"What the Guardian account shows is an Obama administration looking to blame Israel for the failure of its policy of attempting to appease the likes of Iranian dictator Ayatollah Ali Khamenei and President Mahmoud Ahmadinejad.
"Come September, US President Barack Obama is going to have a difficult time of it. He set a September deadline for his strategy of diplomatically courting the mullahs. This policy involves deferring further sanctions against Teheran and all but openly renouncing the option of using military force to destroy Iran's nuclear installations while waiting politely for the mullahs to sit down for tea with US officials.
"Far from accepting Obama's offer, the Iranians have spit on it. Indeed, they have been too busy brutalizing their own people and building bombs and missiles to even respond to him directly. Instead, they have signaled their contempt for Obama by promoting known arch-terrorists to high office. For instance, Ahmadinejad just appointed Ahmad Vahidi, the suspected mastermind of the 1994 bombing of the AMIA Jewish center in Buenos Aires that killed 85 people and the 1996 Khobar Towers bombing in Saudi Arabia where 19 US servicemen and women were murdered to serve as defense minister.
"In support of Obama's appeasement efforts, both the House and the Senate Foreign Relations committees set aside veto-proof bills that would place sanctions on companies exporting refined fuel to Iran. But Congress, now on summer recess, reconvenes in September and members are anxiously awaiting a green light from the White House to put the bills before a vote.
"So unless something saves him, Obama will look like quite a fool next month. His appeasement policy has given the mullahs eight precious months of unimpeded work at their nuclear installations. Their uranium enrichment facility at Natanz is now operating some 5,000 centrifuges, with another 2,400 centrifuges about to go on line. That is an eightfold increase in centrifuge activity from a year ago.
"Obama now turns to Israel to avoid embarrassment. If he can convince Prime Minister Binyamin Netanyahu that the White House will only get serious about Iran's nuclear weapons program if Netanyahu freezes Jewish building in Judea, Samaria and Jerusalem, then Obama can present his sudden willingness to sign on to veto-proof congressional sanctions legislation not as a consequence of his own failure, but as a result of Israeli pressure.
"If Obama succeeds in getting Netanyahu on board, the American media discussion of sanctions will focus on the issue of Israeli power over US policy. The so-called Israel lobby will be pummeled as pundits argue about whether Obama was right or wrong to succumb to Israeli pressure to support congressional sanctions. No one will remember that Obama was forced to support the sanctions because he had no other choice, since next month his engagement policy will become indefensible.
"On the other hand, if Israel refuses to play ball and doesn't provide Obama with a concession which he will be 'forced' to pay for with a harder line on Iran, then he will still have to adopt a harder line. In this case, however, it will be attributed to the failure of his appeasement policy toward Iran rather than to the success of his Middle East diplomacy against Israel.
"Obama's apparent interest in setting Israel up as the fall guy for the failure of his engagement policy is the same policy he will doubtless follow if matters continue on course and Teheran acquires nuclear weapons. At that point, Obama can be counted on to claim that it was Israel's recalcitrance in the negotiations with the Palestinians or the Syrians or the Lebanese that forced the mullahs' hands. That is, he will say it is the absence of 'progress' in the 'peace process' due to whatever imagined Israeli intransigence that made it impossible for the Iranian 'moderates' to convince the 'hardliners' to give up their nuclear weapons program.
"In Obama's defense, it should be noted that at least he worries about being embarrassed by the failure of his Iran policy. He knows that the overwhelming majority of Americans consider Iran to be an enemy of their country. In a poll of US voters taken in May, some 80 percent of Americans claimed that a nuclear-armed Iran would constitute a threat to US national security and 57% said that Israel would be justified in launching a preemptive strike against Iran's nuclear installations."
Read the entirety of Glick's analysis. It is well worth the time.
Obama's realization that his dogmas and agendas are so out-of-step with the majority American people has caused him to fall back upon his blame-the-others strategies. This is hardly surprising, especially to those familiar with academic circles. In the privileged and sequestered realm of academia, egos, grants, budgets and emotional attachments to pet theories combine to produce a constant wrangling which often results in the more pedestrian forms of political deceit-- namely blaming others and loudly calling opponents liars. This is especially true when dealing with the highly interpretive soft sciences (such as literary theory).
Much has been made of Obama's scholarly background, mostly by those who have little actual understanding of the internal workings of academia. Perhaps they're correct in ways they never meant. After all, the pettiness, arrogance, and simplistic outlook the Obama administration regularly displays is right out of faculty hallways.
Sunday, August 30, 2009
Health Care Serfdom
Check out this article from American Thinker by Andrew Foy and Brenton Stransky. They do a reasonable job of putting the step-by-step problems that come from government controlled health care. Read the entire article.
From the article:
"The government plan will initially be funded through taxing the wealthy and by collecting premiums from enrollees but will quickly outgrow this revenue. It will have to broadly increase taxes on the majority of Americans making it more difficult for them to afford private health insurance.
"At the same time, the government plan will not offer reimbursement rates that match those of private insurers. This will cause healthcare providers to charge individuals more with private coverage to make up for lost revenue at the expense of the government plan. As a result, rates for private insurance will increase.
"Finally, the government will require individuals to purchase coverage that meets a broad set of regulations determined by the government. These burdensome regulations will ensure that only the most costly private plans remain in existence but the government plan will keep its rates lower in comparison by padding itself with taxpayer dollars.
"The result of increasing taxation and private premium rates will push more and more people into the government plan. The number of individuals signing up for the government plan will overwhelm the planners' expectations. In response, the government plan will implement tighter and tighter rationing mechanisms to determine the appropriate allocation of resources. What's best for the individual will be replaced by Obama's mantra, 'what's better for all of us.'
"Only the wealthiest among us, like government officials, will be able to avoid this fate and procure required healthcare services in a timely fashion by traveling to places that provide it. However, in the future it won't be the United States but perhaps India or China. And so ends the road to healthcare serfdom.
"President Obama and liberals in Congress would no doubt mock the above scenario and say it could only be perpetrated by a Nazi, racist or someone seriously delusional at best. According to the President, a "government option" will not only be self-sustaining (after an initial infusion of taxpayer dollars) but will benefit every American (even those who are happy with their current coverage) by keeping private insurers honest and their premium rates reasonable. However, a review of recent history proves these claims to be disingenuous."
One only has to look to the UK to see the eventual results of socialized health care, and look to Canada to see the same scenario playing out in a distinctly Canadian manner.
From the article:
"The government plan will initially be funded through taxing the wealthy and by collecting premiums from enrollees but will quickly outgrow this revenue. It will have to broadly increase taxes on the majority of Americans making it more difficult for them to afford private health insurance.
"At the same time, the government plan will not offer reimbursement rates that match those of private insurers. This will cause healthcare providers to charge individuals more with private coverage to make up for lost revenue at the expense of the government plan. As a result, rates for private insurance will increase.
"Finally, the government will require individuals to purchase coverage that meets a broad set of regulations determined by the government. These burdensome regulations will ensure that only the most costly private plans remain in existence but the government plan will keep its rates lower in comparison by padding itself with taxpayer dollars.
"The result of increasing taxation and private premium rates will push more and more people into the government plan. The number of individuals signing up for the government plan will overwhelm the planners' expectations. In response, the government plan will implement tighter and tighter rationing mechanisms to determine the appropriate allocation of resources. What's best for the individual will be replaced by Obama's mantra, 'what's better for all of us.'
"Only the wealthiest among us, like government officials, will be able to avoid this fate and procure required healthcare services in a timely fashion by traveling to places that provide it. However, in the future it won't be the United States but perhaps India or China. And so ends the road to healthcare serfdom.
"President Obama and liberals in Congress would no doubt mock the above scenario and say it could only be perpetrated by a Nazi, racist or someone seriously delusional at best. According to the President, a "government option" will not only be self-sustaining (after an initial infusion of taxpayer dollars) but will benefit every American (even those who are happy with their current coverage) by keeping private insurers honest and their premium rates reasonable. However, a review of recent history proves these claims to be disingenuous."
One only has to look to the UK to see the eventual results of socialized health care, and look to Canada to see the same scenario playing out in a distinctly Canadian manner.
Saturday, August 29, 2009
UK's "Times Online" Headline: Lockerbie bomber 'set free for oil'
According to Jason Allardyce of the Sunday Times (h/t Instapundit) the release of Abdelbaset Ali Mohmed al-Megrahi was an issue on the table during negotiations between Libya and British Petroleum.
"The British government decided it was 'in the overwhelming interests of the United Kingdom' to make Abdelbaset Ali Mohmed al-Megrahi, the Lockerbie bomber, eligible for return to Libya, leaked ministerial letters reveal.
"Gordon Brown’s government made the decision after discussions between Libya and BP over a multi-million-pound oil exploration deal had hit difficulties. These were resolved soon afterwards."
And later in the article: "Edward Davey, the Liberal Democrat foreign affairs spokesman, said: 'This is the strongest evidence yet that the British government has been involved for a long time in talks over al-Megrahi in which commercial considerations have been central to their thinking.'"
The claim is that these leaked details of the negotiations had nothing to do with the actual release of al-Megrahi.
"A Ministry of Justice spokesman denied there had been a U-turn, but said trade considerations had been a factor in negotiating the prisoner exchange deal. He said Straw [the justice secretary Jack Straw] had unsuccessfully tried to accommodate the wish of the Scottish government to exclude Megrahi from agreement.
"The spokesman claimed the deal was ultimately 'academic' because Megrahi had been released on compassionate grounds: 'The negotiations on the [transfer agreement] were part of wider negotiations aimed at the normalisation of relations with Libya, which included a range of areas, including trade.'"
Hmm... Does anyone else find this a trifle maddening?
"The British government decided it was 'in the overwhelming interests of the United Kingdom' to make Abdelbaset Ali Mohmed al-Megrahi, the Lockerbie bomber, eligible for return to Libya, leaked ministerial letters reveal.
"Gordon Brown’s government made the decision after discussions between Libya and BP over a multi-million-pound oil exploration deal had hit difficulties. These were resolved soon afterwards."
And later in the article: "Edward Davey, the Liberal Democrat foreign affairs spokesman, said: 'This is the strongest evidence yet that the British government has been involved for a long time in talks over al-Megrahi in which commercial considerations have been central to their thinking.'"
The claim is that these leaked details of the negotiations had nothing to do with the actual release of al-Megrahi.
"A Ministry of Justice spokesman denied there had been a U-turn, but said trade considerations had been a factor in negotiating the prisoner exchange deal. He said Straw [the justice secretary Jack Straw] had unsuccessfully tried to accommodate the wish of the Scottish government to exclude Megrahi from agreement.
"The spokesman claimed the deal was ultimately 'academic' because Megrahi had been released on compassionate grounds: 'The negotiations on the [transfer agreement] were part of wider negotiations aimed at the normalisation of relations with Libya, which included a range of areas, including trade.'"
Hmm... Does anyone else find this a trifle maddening?
Friday, August 28, 2009
Personal Update
Well, it looks like my hard drive is a complete loss with no chance for an expensive recovery (there's a 2% chance of this kind of failure according to the recovery lab). It took with it the sole draft of my novel in progress-- about 120 pages of work. Ouch...
After having several days to dwell upon the unhappy situation, I've decided to look at this as a sort-of early chance for a radical revision. It basically means that I have to start over and retread the same scenes and pages and try to recapture the same interest and excitement that I had for the work back in late May. Not a happy situation, but oh, well...
Anyway, I'm going to be distracted for a time as I gather up and organize info and programs that were backed-up and begin re-installing it. In the meantime, I should be back blogging with some regularity quite soon... as long as I don't get hit by a meteorite or something (with the way my luck's been going, I don't discount the possibility).
Thanks!
Yukio Ngaby
After having several days to dwell upon the unhappy situation, I've decided to look at this as a sort-of early chance for a radical revision. It basically means that I have to start over and retread the same scenes and pages and try to recapture the same interest and excitement that I had for the work back in late May. Not a happy situation, but oh, well...
Anyway, I'm going to be distracted for a time as I gather up and organize info and programs that were backed-up and begin re-installing it. In the meantime, I should be back blogging with some regularity quite soon... as long as I don't get hit by a meteorite or something (with the way my luck's been going, I don't discount the possibility).
Thanks!
Yukio Ngaby
Monday, August 24, 2009
More Apologies and Links Regarding Congressional Health Care "Reform"
Again, I have to apologize for not getting out more on the Senate's HELP Committee health care reform bill as promised. I've been running about mindlessly trying to get my half-written novel back off my crashed hard drive. It now appears that I'll have to send it out and have the drive disassembled in a clean room at a rather substantial cost... Ah, well...
In the meantime, William A. Jacobson at Legal Insurrection has some excellent information about the health care bills including:
"Provisions in the Senate HELP Committee draft bill creating rules and regulations governing food disclosures at fast food restaurants and in vending machines."
The creation of massive and intrusive bureaucracies.
The IRS playing "a key role in monitoring and enforcing health care mandates against individual taxpayers."
The sudden tax on your "mere existence."
The provision that the "IRS To Decide Amount of Taxation."
And here is Jacobson's own suggestions of throwing the bills completely away.
All his posts are concise and presented with evidence and citation. Highly recommended. Check it out.
Quite Rightly at Bread upon the Waters has some chilling statistics on the survival rates of cancer in the US as compared to Britain. Here's a spoiler-- the US is the top 3 in the survival rates and Britain hovers about 20.
A quote from the Sunday Times in Quite Rightly's post: "For example, a woman with breast cancer is 88% more likely to die within five years of diagnosis in Britain than in America. A man with prostate cancer is six times as likely to die within five years in Britain than in America. For various types of colon and rectal cancers, both men and women are 40% more likely to die in Britain than in America within five years of diagnosis." Check out the post. It has highly important information (both my parents are cancer survivors, as are two aunts, an uncle, and three good friends).
Again, I hope to get more on the Senate HELP Committee bill up when I can, but the distractions from my professional life are a little acute right now (i.e. I'm going insane, feeling sharp pains behind my eyes, and am incredibly mad at myself for not backing up the data-- foolish and novice mistake). Check these out and I'll be back, hopefully, within a week.
Thanks.
In the meantime, William A. Jacobson at Legal Insurrection has some excellent information about the health care bills including:
"Provisions in the Senate HELP Committee draft bill creating rules and regulations governing food disclosures at fast food restaurants and in vending machines."
The creation of massive and intrusive bureaucracies.
The IRS playing "a key role in monitoring and enforcing health care mandates against individual taxpayers."
The sudden tax on your "mere existence."
The provision that the "IRS To Decide Amount of Taxation."
And here is Jacobson's own suggestions of throwing the bills completely away.
All his posts are concise and presented with evidence and citation. Highly recommended. Check it out.
Quite Rightly at Bread upon the Waters has some chilling statistics on the survival rates of cancer in the US as compared to Britain. Here's a spoiler-- the US is the top 3 in the survival rates and Britain hovers about 20.
A quote from the Sunday Times in Quite Rightly's post: "For example, a woman with breast cancer is 88% more likely to die within five years of diagnosis in Britain than in America. A man with prostate cancer is six times as likely to die within five years in Britain than in America. For various types of colon and rectal cancers, both men and women are 40% more likely to die in Britain than in America within five years of diagnosis." Check out the post. It has highly important information (both my parents are cancer survivors, as are two aunts, an uncle, and three good friends).
Again, I hope to get more on the Senate HELP Committee bill up when I can, but the distractions from my professional life are a little acute right now (i.e. I'm going insane, feeling sharp pains behind my eyes, and am incredibly mad at myself for not backing up the data-- foolish and novice mistake). Check these out and I'll be back, hopefully, within a week.
Thanks.
Friday, August 21, 2009
Computer Crash
Man, when it rains it pours...
Well my computer's hard drive crashed on me last night-- not this computer obviously. No, I don't really have anything all that important on this computer. Rather it was my work computer that I keep separate from the internet. Which means I lost my entire novel (what I had written of it anyway-- about 120 pages so far)... I normally back my stuff up on jump drives, but the cats were knocking it around on the floor and the computer was running perfectly so... Ah hell... After I pull my fist out of my wall, I'll have to take the computer in and see what can be recovered off the hard drive.
So wish me luck. I hate to lose several months of work this way, but...
Well my computer's hard drive crashed on me last night-- not this computer obviously. No, I don't really have anything all that important on this computer. Rather it was my work computer that I keep separate from the internet. Which means I lost my entire novel (what I had written of it anyway-- about 120 pages so far)... I normally back my stuff up on jump drives, but the cats were knocking it around on the floor and the computer was running perfectly so... Ah hell... After I pull my fist out of my wall, I'll have to take the computer in and see what can be recovered off the hard drive.
So wish me luck. I hate to lose several months of work this way, but...
Thursday, August 20, 2009
Sorry for the Absence
I'm sorry for being gone so long. I've been putting in a lot of hours on a couple of different projects, and it finally caught up with me-- I've been down with some virus or something. I'll be up and back soon. I'll be back to work on part 2 of the Senate HELP Committee's bill, and it should be up soon, but probably not in as much detail as I would like.
Thanks.
Thanks.
Tuesday, August 18, 2009
Added New Link! "The Chinese Jar" Blog
I've just added a new blog by Chris M. the same blogger of snaggletoothie of the Loyal Opposition-- The Chinese Jar to the Blog List.
The Chinese Jar promises to focus on the great books and, hopefully, be a forum to discuss the ideas contained within. As Chris M. says : "The great books are the books that have made major contributions to the great conversation. And that conversation is the ongoing discussion through the centuries of the major issues that have occupied mankind. Here are some of those questions. What does it mean to be human? What are good and evil? Is there a God? What is the nature of God? What is the best way to organize a government? How much can we know about the world? What is the nature of beauty? How should I behave towards my fellow men?"
It's exciting for me, although right at this moment, with the health care rush and two different bills to chug through, I doubt I'll be able to read Joyce's "Sisters" and "Dubliners" with the attention and clear mind such work requires any time soon. But still check it out if you like great literature. Discussing great ideas has kept me sane for the passed 23 years (since I was 13).
The Chinese Jar promises to focus on the great books and, hopefully, be a forum to discuss the ideas contained within. As Chris M. says : "The great books are the books that have made major contributions to the great conversation. And that conversation is the ongoing discussion through the centuries of the major issues that have occupied mankind. Here are some of those questions. What does it mean to be human? What are good and evil? Is there a God? What is the nature of God? What is the best way to organize a government? How much can we know about the world? What is the nature of beauty? How should I behave towards my fellow men?"
It's exciting for me, although right at this moment, with the health care rush and two different bills to chug through, I doubt I'll be able to read Joyce's "Sisters" and "Dubliners" with the attention and clear mind such work requires any time soon. But still check it out if you like great literature. Discussing great ideas has kept me sane for the passed 23 years (since I was 13).
Monday, August 17, 2009
Congressman's Schrader's Telephone Town Hall is Buggy
I just finished listening to Congressman Kurt Schrader's (my congressional rep here in Salem) telephone town hall. I have no idea how it went for the rest of the people, but I was frustrated beyond belief.
I was told I would be called several minutes before 7 pm, but was instead called at 7:06 pm after the town hall had already started. If there were any instructions at the beginning, then I missed them. I punched in the keys to be placed in a queue for questions, then waited the entire remaining fifty-four minutes (God forbid that the "meeting" should go over the allotted 1 hour) while a malfunctioning recorded voice would break in between the questions and answers every 45 seconds with "press the th-th-th-th-th key now." I hit the pound key several times (I heard the word "pound" in there once-- and I seriously mean once) which had absolutely no discernible effect on anything. I never talked to an operator, nor any human being. The constant automated interruptions made it almost impossible to follow the questions and answers, and I learned next to nothing from the whole technically incompetent affair.
While refusing to meet with his constituents face-to-face, Schrader and his people were unable to demonstrate even the most basic technical abilities to set-up and handle a touch tone phone menu. Local talk radio shows (which I have never called in to-- to be fair) seem to run things better than this. And he wants us to believe that Congress should handle our health care insurance... This experience does not fill me with confidence.
NOTE: You may notice that the post time of this entry is 7:56pm-- 4 minutes before the town hall was over. This is because after 50 minutes of "th-th-th-th-th key now" I opened up the "new post" to write about my experience, which means this entry was time-stamped at that moment. I stayed with the "town hall" till the end and did not begin writing until after I hung up after its conclusion.
I was told I would be called several minutes before 7 pm, but was instead called at 7:06 pm after the town hall had already started. If there were any instructions at the beginning, then I missed them. I punched in the keys to be placed in a queue for questions, then waited the entire remaining fifty-four minutes (God forbid that the "meeting" should go over the allotted 1 hour) while a malfunctioning recorded voice would break in between the questions and answers every 45 seconds with "press the th-th-th-th-th key now." I hit the pound key several times (I heard the word "pound" in there once-- and I seriously mean once) which had absolutely no discernible effect on anything. I never talked to an operator, nor any human being. The constant automated interruptions made it almost impossible to follow the questions and answers, and I learned next to nothing from the whole technically incompetent affair.
While refusing to meet with his constituents face-to-face, Schrader and his people were unable to demonstrate even the most basic technical abilities to set-up and handle a touch tone phone menu. Local talk radio shows (which I have never called in to-- to be fair) seem to run things better than this. And he wants us to believe that Congress should handle our health care insurance... This experience does not fill me with confidence.
NOTE: You may notice that the post time of this entry is 7:56pm-- 4 minutes before the town hall was over. This is because after 50 minutes of "th-th-th-th-th key now" I opened up the "new post" to write about my experience, which means this entry was time-stamped at that moment. I stayed with the "town hall" till the end and did not begin writing until after I hung up after its conclusion.
Incoming President of the Canadian Medical Association Says "System is Imploding"
The incoming president of the Canadian Medical Association had a few strong words regarding Canada's single-payer system. saying, among other things, that "[w]e all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize."
From a Canadian Press article by Jennifer Graham (h/t Instapundit): "The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.
"Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.
"'We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize,' Doing said in an interview with The Canadian Press.
"'We know that there must be change,' she said. 'We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands.'
"The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.
"His thoughts on the issue are already clear. Ouellet has been saying since his return that 'a health-care revolution has passed us by,' that it's possible to make wait lists disappear while maintaining universal coverage and 'that competition should be welcomed, not feared.'
"In other words, Ouellet believes there could be a role for private health-care delivery within the public system."
I mentioned this in my previous post, but about Obama's floating of the no-public-option balloon, but I feel this story should have it own post. Time and again, we have all heard the we-should-go-be-like-Canada line. Michael Moore professed such a view in "Sicko," and various bloggers, commenters, political pundits, and such will bring blithely bring up Canada's single-payer system as an example to follow.
Do not be misled. After its inception in and around 1962, Canada's system has slowly collapsed, and is notorious for its long waits in a country that only has a population of somewhere near 34 million. The US has a population of slightly less than 306 million people (not counting illegal immigrants and visitors on student visas, or seeking amnesty etc.), 9 times as many people.
Canada's system is, predictably, following Britain's single-payer economic model, starting off amid high hopes, and then crashing as it attempts to control prices and lives off other countries' medical innovations. A single-payer system is not self-sustaining-- and it is not sustainable.
We'll see if the MSM picks up on this story, especially considering its inconvenient timing. I'm betting it will not.
From a Canadian Press article by Jennifer Graham (h/t Instapundit): "The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.
"Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.
"'We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize,' Doing said in an interview with The Canadian Press.
"'We know that there must be change,' she said. 'We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands.'
"The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.
"His thoughts on the issue are already clear. Ouellet has been saying since his return that 'a health-care revolution has passed us by,' that it's possible to make wait lists disappear while maintaining universal coverage and 'that competition should be welcomed, not feared.'
"In other words, Ouellet believes there could be a role for private health-care delivery within the public system."
I mentioned this in my previous post, but about Obama's floating of the no-public-option balloon, but I feel this story should have it own post. Time and again, we have all heard the we-should-go-be-like-Canada line. Michael Moore professed such a view in "Sicko," and various bloggers, commenters, political pundits, and such will bring blithely bring up Canada's single-payer system as an example to follow.
Do not be misled. After its inception in and around 1962, Canada's system has slowly collapsed, and is notorious for its long waits in a country that only has a population of somewhere near 34 million. The US has a population of slightly less than 306 million people (not counting illegal immigrants and visitors on student visas, or seeking amnesty etc.), 9 times as many people.
Canada's system is, predictably, following Britain's single-payer economic model, starting off amid high hopes, and then crashing as it attempts to control prices and lives off other countries' medical innovations. A single-payer system is not self-sustaining-- and it is not sustainable.
We'll see if the MSM picks up on this story, especially considering its inconvenient timing. I'm betting it will not.
Obama's Dropping of Public Option is Simply a Balloon
I'm still struggling through the Senate HELP Bill, and will get up pt. 2 of my post soon. The Gateway aspect of the bill is complicated and tough to both understand and to envision the likely consequences. I'm still working on it, though.
In the mean time, Obama is reportedly backing away from the public option he wedded to the banner of health care reform. Via Philip Elliot at the AP: "President Barack Obama is willing to embrace insurance cooperatives over a government-run plan as the White House faces mounting opposition to its broad overhaul of the nation's health care system.
"Bowing to Republican pressure and offering political cover to fiscally conservative Democrats, Obama's administration signaled on Sunday that it is ready to abandon the idea of giving Americans the option of government-run insurance. The shift leaves open a chance for compromise with Republicans that probably would enrage Obama's liberal supporters but could deliver a much-needed victory on a top domestic priority.
"Officials from both political parties are looking for concessions while Congress is on an August recess. Facing tough audiences, lawmakers and the White House are looking for a way to cover the nation's almost 50 million uninsured while maintaining political standing."
Notice again the "50 million uninsured" number. Still reporting the lie... Once again a more accurate number of people who are not insured and do not qualify for existing government programs is between 16 and 8.2 million. Not 50 million.
This is neither a victory for opponents, nor a surrender from that administration. Obama's simply sending out feelers to see what he can get away with. Tied to a promise of health care reform, Obama needs to pass something with that label attached. All he is likely doing is weighing the votes gained in Congress with the backlash from the Left and seeing if it's politically feasible. Do not get your hopes up yet. Michelle Malkin covers this in further detail and with more links.
The public option in any form is a Trojan horse for single-payer health care. Private insurers cannot compete with an entity supported by tax dollars and not burdened with the need for profits. The poor quality of such health care and the deterioration of the system are both demonstrable inevitabilities. Yet, federal oversight of such co-ops would still create a federally mandated health-ration system. If an entity such as Health Benefits Advisory Committee (in the HR 3200 bill) or the Medical Advisory Council (in the Senate HELP Committee's bill) regulates coverage, we will have an inefficient, lobbying-for-benefits health care system. It will be worse then it is now and actual effective reform will be that much harder to bring about. It could also very well set the stage for an inclusion of a public option-- after over-regulation fails.
Canada is already talking about opening up their system to private insurers. From a Canadian Press article by Jennifer Graham: "The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.
"Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.
"'We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize,' Doing said in an interview with The Canadian Press.
"'We know that there must be change,' she said. 'We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands.'
"The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.
"His thoughts on the issue are already clear. Ouellet has been saying since his return that 'a health-care revolution has passed us by,' that it's possible to make wait lists disappear while maintaining universal coverage and 'that competition should be welcomed, not feared.'
"In other words, Ouellet believes there could be a role for private health-care delivery within the public system."
Canada acknowledges that their system "is imploding." Maybe we need to get our heads of the sand, and look around the world without rose-tinted glasses.
Friday, August 14, 2009
The Senate HELP Committee Bill IS a Trojan Horse for Single-Payer Pt. 1
I've spent many hours slogging my way through the Senate Health, Education, Labor and Pensions (HELP) Committee bill released to the public. It is 615 pages long. I have gone through them all, the first 137 pages in detail. I offer my opinion that this is a bad bill, that seems to initiate the end of private health care insurance and establishes the beginnings of single-payer health care. Before you roll your eyes, stop reading, and dismiss me as an un-American corporate shill, or nazi, or racist, or whatever baseless insult you may wish to throw at me, I say now that I will cite evidence from the bill itself throughout my argument.
The beginnings of the bill, rather euphemistically named the "Affordable Health Choices Act" initially amends The Public Health Service Act (full text here), and intrusively regulates private health insurance policies for the first 30 pages (pgs 7 - 36).
Among the numerous regulations is:
1) A "guaranteed availability of coverage" As written: "each health insurance issuer that offers health insurance coverage in the individual or group market in a State must accept every employer and individual and individual in the State that applies for such coverage." (page 9, sec 2702)
2) A "guaranteed renewability of coverage" As written: "'Except as provided in this section, if a health insurance issuer offers health insurance coverage in the individual or group market, the issuer must renew or continue in force such coverage at the option of the plan sponsor of the plan, or the individual, as applicable." (page 10 sec. 2703)
3) A requirement to give premium rebates determined, not by the company, but by the presidential administration: "A health insurance issuer offering group or individual health insurance coverage shall provide an annual rebate to each enrolee under such plan or coverage on a pro rata basis in the amount by which the amount of premium revenue expended on activities described in subsection (a)(3) exceeds-- (A) [...] a percentage that the Secretary [of Health and Human Services] shall by regulation determine based on the distribution of such percentages across such issuers;" [emphasis mine] (page 11 sec 2704).
One might ask how the Secretary of Health and Human Services (currently Kathleen Sebelius) could determine the percentage of this. Well, the answer is reasonably simple. For all intents and purposes the insurers would have to open their accounting books for the Secretary (page 10 sec. 2704).
4) The government will require insurers to notify their members if the insurance plan does not meet the Medical Advisory Council's (more on MAC later-- for right now it's a council handpicked by the Secretary of Health to set standards for health insurance plans) minimum qualifying standards (page 12), which I can reasonably predict would cause the members to drop their coverage or demand their employers to switch coverage. In other words, MAC's word is law in regulating i.e. rationing medical coverage.
5) The bill forbids discriminating against the insured based on health status (page 12 sec, 2706). Among such conditions that cannot be factored in are: (1) health status (2) medical condition (3) claims experience (4) medical history (5) evidence of insurability (6) "[a]ny other health status-related factor determined by the Secretary [of Health]."
6) Okay. This one's a biggie. Sec. 2707 (page 13) of the bill is entitled "Ensuring the Quality of Care" and basically could require health plans to pay bonuses to doctors for following government standardized guidelines on care. Essentially, this suggests that insurance companies could be forced to provide "incentives" for doctors to yield to federal bureaucracies' guidelines rather than their own diagnoses.
Now I disagree with the other regulations (for reasons I'll discuss below), but this one angers me. While Obama is ridiculously claiming that doctors have financial incentives to cut the legs off of diabetics rather than treating them, this portion of the bill requires health plans, by law, to provide incentives for doctors to follow guidelines "for excellence of care," rather than a doctor's personal experience, expertise, or the individual diagnosis.
Here is the language in the bill: "A group health plan [...] shall develop and implement a reimbursement structure for making payments to health care providers that provides for-- (1) the provision of high quality health care under the plan or coverage in a manner that includes-- [...] (C) the implementation of activities to improve safety and reduce medical errors through the appropriate use of clinical practices, evidence based medicine, and health information technology under the plan or coverage; [emphasis mine]"
Okay. Now at first this might look like simply an incentive to reward excellence. A gold star on a paper... Okay fine. But who determines what is "the appropriate use of clinical practices," etc. and by what criteria? Who determines the criteria even? None of this appears to be specified in the bill, but given the intrusiveness of the government regulations and MAC in this bill, combined with Obama's own admonishments about the immoral greediness of surgeons, where would you expect all of the criteria to come from?
7) The bill goes on to define a member's children covered by health plans as being "not more than 26 years of age" (page 17), So a member's 25-year-old son or daughter would be required to be covered by their parents' health plan. Don't be too up in arms about children being 25-- I believe the cut-off age is currently 24.
8) A health plan cannot establish annual or lifetime limits on benefits (page 17 sec. 2710).
As you may have noticed, all of this happens in the first 18 pages of the bill, and the 8 points of regulation are simply points I've highlighted to demonstrate the micro-management of health providers that this bill attempts. Various other regulatory measures exist in various sections and paragraphs. I encourage you to read this bill for yourself, but definitely read the first 20 pages. It will give you a good idea of the sort of constricting regulation and powers Congress and the Secretary of Health and Human Services will have over your health care. And it's a lot.
These Government mirco-managing regulations have a long history of failure. This is hardly surprising as the governmental rules and regulations that businesses must abide by are almost never written by people who actually have experience in the field that they wish to regulate. They are almost always written by career politicians, whose primary goal is to satisfy their constituencies in the short-term and be re-elected-- not to create businesses that can remain profitable and competitive in a market. That's not even in the cards.
We are expected to believe that these men and women can tell successful businesses how to run their companies and remain profitable and viable-- even though the stated purpose of this reform bill is to provide universal coverage and not sustainable health insurers.
Let us take Obama's own Post Office analogy for example. At the Portsmouth town hall (video here) Obama said "'Now, I recognize, though, you make a legitimate -- you raise a legitimate concern. People say, well, how can a private company compete against the government? And my answer is that if the private insurance companies are providing a good bargain, and if the public option has to be self-sustaining -- meaning taxpayers aren't subsidizing it, but it has to run on charging premiums and providing good services and a good network of doctors, just like any other private insurer would do -- then I think private insurers should be able to compete. They do it all the time.' (Applause.)
"I mean, if you think about -- if you think about it, UPS and FedEx are doing just fine, right? No, they are. It's the Post Office that's always having problems."
While this comparison is nonsense (as I've asserted in another post), the assertion about the Post Office is true enough. The Post Office is on track to lose an astonishing $7 billion. From the NY Times article by Joe Nocera:
"Consider the plight of John E. Potter, the chief executive of the second-largest employer in America. On the one hand, he has a guaranteed monopoly for much of his business. On the other hand, monopoly or not, the combination of the Internet and the recession is absolutely crushing his company, just as it is for so many other companies across the country. His last quarter’s results, which were announced on Wednesday, revealed a loss of $2.4 billion. The business is on track to lose a staggering $7 billion in 2009, on around $68 billion in revenue. That’s practically General Motors territory.
"What can he do to fix the situation? Surprisingly little. His employees have clauses in their union contracts that forbid layoffs. Nor can he renegotiate their gold-plated benefits, the way, say, the auto companies did when their backs were against the wall. Political pressure makes it nearly impossible to shut down any of his company’s 34,000 facilities, no matter how outmoded or little used. He can borrow money, but under the law, he can add only $3 billion in debt a year — an amount that isn’t going to come close to covering his losses.
"Oh, and get this. Every year between now and 2016, he has to put aside over $5 billion to finance health benefits for future employees. You read that right: future employees. There isn’t another business in the country that finances benefits for employees it hasn’t even hired yet.
"Welcome to John Potter’s world. He’s the nation’s postmaster general. Yes, that’s right: for the last nine years, he has run the United States Postal Service, which, since 1970, when it stopped being a government department and started becoming self-sufficient, has been the oddest of ducks. It is expected to operate as a business, turning a profit and so on, and yet it is still subject to Congressional oversight and all sorts of legal constraints, like that ridiculous health benefit prefinancing for future employees, which was part of a big 2006 postal reorganization bill. (Its main purpose, it would seem, is government accounting: those funds get counted against the federal deficit.) [emphasis mine]"
Doesn't sound so great, does it? This merely begins to illustrate the difficulty of running a business with government micro-management. And this financial trouble comes in spite of a government enforced monopoly (the Post Office is the only entity allowed by federal law to deliver first class mail to your mailbox) and the huge advantages that the Post Office enjoys "It pays no federal tax, no state tax, and no parking tickets. Often they don't even pay rent. They don't pay to register their vehicles. Check out a license plate spot on a post office truck -- nothing there."
Yet, we are to believe that private health care insurers, burdened with these new micro-managing regulations and intrusive oversights, are going to remain viable businesses in the years to come. We are actually expected to believe that even though the federal government can mandate that a private health plan must accept every applicant for life (page 9 & 10), that the feds demands and the presidential administration determines annual rebates of premium payments (page 11), that private insurers must open their books to the administration, (page 10), that a presidential council (MAC again-- more on MAC in the next post) determines the extent of required coverage, that requires private insurers to pay incentives for doctors to follow the government band wagon on treatment (page 14), can remain viable businesses in this government-contrived market. As government programs like medicare, medicaid and social security rush toward insolvency, and the Post Office hemorrhages cash, do you think government micro-management and mandates will not do this to private health insurance?
Rather laughably, the Senate bill throws in a "no changes to existing coverage" provision (page 19). Basically it freezes a current plan as is, not allowing others to enroll in the plan except for families of existing members (natch). As medical costs increase (tests, diagnosis equipment, etc.), how can a private insurance company hope to stay in business if it cannot expand? When Obama and other politicians says these reforms will allow you to keep your insurance and doctor, it is deceptive, if not an outright lie. You can keep you insurance (provided your employer doesn't switch), but your insurance plan is doomed to fold-- probably within a year (since most insurance plans change annually).
While these changes in insurance requirements may sound good on the surface, it is extraordinarily unlikely that they are sustainable for private health companies-- even if there was no competition from a public option (as Obama has openly admitted to numerous times including in the Post Office analogy) or a government supervised health exchange (what is called the Gateway in this Senate HELP Committee health bill beginning on page 40).
Yes, health care insurance reform is doubtlessly needed, especially among people saddled with the federally funded program medicaid (whom Michelle Obama actively dumped onto other community hospitals while a senior vice president at the University of Chicago Medical Center). However, the format of this strict government oversight by both Congress and the presidency (how well will that work with a Republican Congress and Democrat president- or vice versa), contained in this bill is not the answer. This bill will create an untenable market for private insurers and will put them out of business, especially as they compete with a tax-funded public option. I have to wonder if that is not, in part, the intent of this bill...
I will have more on the Medical Advisory Council (MAC), the public option (which will lead to single payer insurance) and the American Health Benefit Gateway (the proposal for the federal government's exchange) in part 2 of this post up hopefully by Sunday.
The beginnings of the bill, rather euphemistically named the "Affordable Health Choices Act" initially amends The Public Health Service Act (full text here), and intrusively regulates private health insurance policies for the first 30 pages (pgs 7 - 36).
Among the numerous regulations is:
1) A "guaranteed availability of coverage" As written: "each health insurance issuer that offers health insurance coverage in the individual or group market in a State must accept every employer and individual and individual in the State that applies for such coverage." (page 9, sec 2702)
2) A "guaranteed renewability of coverage" As written: "'Except as provided in this section, if a health insurance issuer offers health insurance coverage in the individual or group market, the issuer must renew or continue in force such coverage at the option of the plan sponsor of the plan, or the individual, as applicable." (page 10 sec. 2703)
3) A requirement to give premium rebates determined, not by the company, but by the presidential administration: "A health insurance issuer offering group or individual health insurance coverage shall provide an annual rebate to each enrolee under such plan or coverage on a pro rata basis in the amount by which the amount of premium revenue expended on activities described in subsection (a)(3) exceeds-- (A) [...] a percentage that the Secretary [of Health and Human Services] shall by regulation determine based on the distribution of such percentages across such issuers;" [emphasis mine] (page 11 sec 2704).
One might ask how the Secretary of Health and Human Services (currently Kathleen Sebelius) could determine the percentage of this. Well, the answer is reasonably simple. For all intents and purposes the insurers would have to open their accounting books for the Secretary (page 10 sec. 2704).
4) The government will require insurers to notify their members if the insurance plan does not meet the Medical Advisory Council's (more on MAC later-- for right now it's a council handpicked by the Secretary of Health to set standards for health insurance plans) minimum qualifying standards (page 12), which I can reasonably predict would cause the members to drop their coverage or demand their employers to switch coverage. In other words, MAC's word is law in regulating i.e. rationing medical coverage.
5) The bill forbids discriminating against the insured based on health status (page 12 sec, 2706). Among such conditions that cannot be factored in are: (1) health status (2) medical condition (3) claims experience (4) medical history (5) evidence of insurability (6) "[a]ny other health status-related factor determined by the Secretary [of Health]."
6) Okay. This one's a biggie. Sec. 2707 (page 13) of the bill is entitled "Ensuring the Quality of Care" and basically could require health plans to pay bonuses to doctors for following government standardized guidelines on care. Essentially, this suggests that insurance companies could be forced to provide "incentives" for doctors to yield to federal bureaucracies' guidelines rather than their own diagnoses.
Now I disagree with the other regulations (for reasons I'll discuss below), but this one angers me. While Obama is ridiculously claiming that doctors have financial incentives to cut the legs off of diabetics rather than treating them, this portion of the bill requires health plans, by law, to provide incentives for doctors to follow guidelines "for excellence of care," rather than a doctor's personal experience, expertise, or the individual diagnosis.
Here is the language in the bill: "A group health plan [...] shall develop and implement a reimbursement structure for making payments to health care providers that provides for-- (1) the provision of high quality health care under the plan or coverage in a manner that includes-- [...] (C) the implementation of activities to improve safety and reduce medical errors through the appropriate use of clinical practices, evidence based medicine, and health information technology under the plan or coverage; [emphasis mine]"
Okay. Now at first this might look like simply an incentive to reward excellence. A gold star on a paper... Okay fine. But who determines what is "the appropriate use of clinical practices," etc. and by what criteria? Who determines the criteria even? None of this appears to be specified in the bill, but given the intrusiveness of the government regulations and MAC in this bill, combined with Obama's own admonishments about the immoral greediness of surgeons, where would you expect all of the criteria to come from?
7) The bill goes on to define a member's children covered by health plans as being "not more than 26 years of age" (page 17), So a member's 25-year-old son or daughter would be required to be covered by their parents' health plan. Don't be too up in arms about children being 25-- I believe the cut-off age is currently 24.
8) A health plan cannot establish annual or lifetime limits on benefits (page 17 sec. 2710).
As you may have noticed, all of this happens in the first 18 pages of the bill, and the 8 points of regulation are simply points I've highlighted to demonstrate the micro-management of health providers that this bill attempts. Various other regulatory measures exist in various sections and paragraphs. I encourage you to read this bill for yourself, but definitely read the first 20 pages. It will give you a good idea of the sort of constricting regulation and powers Congress and the Secretary of Health and Human Services will have over your health care. And it's a lot.
These Government mirco-managing regulations have a long history of failure. This is hardly surprising as the governmental rules and regulations that businesses must abide by are almost never written by people who actually have experience in the field that they wish to regulate. They are almost always written by career politicians, whose primary goal is to satisfy their constituencies in the short-term and be re-elected-- not to create businesses that can remain profitable and competitive in a market. That's not even in the cards.
We are expected to believe that these men and women can tell successful businesses how to run their companies and remain profitable and viable-- even though the stated purpose of this reform bill is to provide universal coverage and not sustainable health insurers.
Let us take Obama's own Post Office analogy for example. At the Portsmouth town hall (video here) Obama said "'Now, I recognize, though, you make a legitimate -- you raise a legitimate concern. People say, well, how can a private company compete against the government? And my answer is that if the private insurance companies are providing a good bargain, and if the public option has to be self-sustaining -- meaning taxpayers aren't subsidizing it, but it has to run on charging premiums and providing good services and a good network of doctors, just like any other private insurer would do -- then I think private insurers should be able to compete. They do it all the time.' (Applause.)
"I mean, if you think about -- if you think about it, UPS and FedEx are doing just fine, right? No, they are. It's the Post Office that's always having problems."
While this comparison is nonsense (as I've asserted in another post), the assertion about the Post Office is true enough. The Post Office is on track to lose an astonishing $7 billion. From the NY Times article by Joe Nocera:
"Consider the plight of John E. Potter, the chief executive of the second-largest employer in America. On the one hand, he has a guaranteed monopoly for much of his business. On the other hand, monopoly or not, the combination of the Internet and the recession is absolutely crushing his company, just as it is for so many other companies across the country. His last quarter’s results, which were announced on Wednesday, revealed a loss of $2.4 billion. The business is on track to lose a staggering $7 billion in 2009, on around $68 billion in revenue. That’s practically General Motors territory.
"What can he do to fix the situation? Surprisingly little. His employees have clauses in their union contracts that forbid layoffs. Nor can he renegotiate their gold-plated benefits, the way, say, the auto companies did when their backs were against the wall. Political pressure makes it nearly impossible to shut down any of his company’s 34,000 facilities, no matter how outmoded or little used. He can borrow money, but under the law, he can add only $3 billion in debt a year — an amount that isn’t going to come close to covering his losses.
"Oh, and get this. Every year between now and 2016, he has to put aside over $5 billion to finance health benefits for future employees. You read that right: future employees. There isn’t another business in the country that finances benefits for employees it hasn’t even hired yet.
"Welcome to John Potter’s world. He’s the nation’s postmaster general. Yes, that’s right: for the last nine years, he has run the United States Postal Service, which, since 1970, when it stopped being a government department and started becoming self-sufficient, has been the oddest of ducks. It is expected to operate as a business, turning a profit and so on, and yet it is still subject to Congressional oversight and all sorts of legal constraints, like that ridiculous health benefit prefinancing for future employees, which was part of a big 2006 postal reorganization bill. (Its main purpose, it would seem, is government accounting: those funds get counted against the federal deficit.) [emphasis mine]"
Doesn't sound so great, does it? This merely begins to illustrate the difficulty of running a business with government micro-management. And this financial trouble comes in spite of a government enforced monopoly (the Post Office is the only entity allowed by federal law to deliver first class mail to your mailbox) and the huge advantages that the Post Office enjoys "It pays no federal tax, no state tax, and no parking tickets. Often they don't even pay rent. They don't pay to register their vehicles. Check out a license plate spot on a post office truck -- nothing there."
Yet, we are to believe that private health care insurers, burdened with these new micro-managing regulations and intrusive oversights, are going to remain viable businesses in the years to come. We are actually expected to believe that even though the federal government can mandate that a private health plan must accept every applicant for life (page 9 & 10), that the feds demands and the presidential administration determines annual rebates of premium payments (page 11), that private insurers must open their books to the administration, (page 10), that a presidential council (MAC again-- more on MAC in the next post) determines the extent of required coverage, that requires private insurers to pay incentives for doctors to follow the government band wagon on treatment (page 14), can remain viable businesses in this government-contrived market. As government programs like medicare, medicaid and social security rush toward insolvency, and the Post Office hemorrhages cash, do you think government micro-management and mandates will not do this to private health insurance?
Rather laughably, the Senate bill throws in a "no changes to existing coverage" provision (page 19). Basically it freezes a current plan as is, not allowing others to enroll in the plan except for families of existing members (natch). As medical costs increase (tests, diagnosis equipment, etc.), how can a private insurance company hope to stay in business if it cannot expand? When Obama and other politicians says these reforms will allow you to keep your insurance and doctor, it is deceptive, if not an outright lie. You can keep you insurance (provided your employer doesn't switch), but your insurance plan is doomed to fold-- probably within a year (since most insurance plans change annually).
While these changes in insurance requirements may sound good on the surface, it is extraordinarily unlikely that they are sustainable for private health companies-- even if there was no competition from a public option (as Obama has openly admitted to numerous times including in the Post Office analogy) or a government supervised health exchange (what is called the Gateway in this Senate HELP Committee health bill beginning on page 40).
Yes, health care insurance reform is doubtlessly needed, especially among people saddled with the federally funded program medicaid (whom Michelle Obama actively dumped onto other community hospitals while a senior vice president at the University of Chicago Medical Center). However, the format of this strict government oversight by both Congress and the presidency (how well will that work with a Republican Congress and Democrat president- or vice versa), contained in this bill is not the answer. This bill will create an untenable market for private insurers and will put them out of business, especially as they compete with a tax-funded public option. I have to wonder if that is not, in part, the intent of this bill...
I will have more on the Medical Advisory Council (MAC), the public option (which will lead to single payer insurance) and the American Health Benefit Gateway (the proposal for the federal government's exchange) in part 2 of this post up hopefully by Sunday.
American College of Surgeons Respond to Obama's Diabetic Leg Amputation Claim
Do you remember when Obama said that doctors had financial incentives to allow diabetics to go untreated until they needed their feet amputated? Yeah, he said that during the Portsmouth town hall.
Here's a transcript, and the quote:
"All I'm saying is let's take the example of something like diabetes, one of—a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family—if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000—immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money."
Well, the American College of Surgeons didn't want to let that one slip by. They've released a statement (h/t newbusters.org).
"The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.
"Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.
"Three weeks ago, the President suggested that a surgeon’s decision to remove a child’s tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient."
Huh... Do they mean surgeons aren't simply harvesting limbs and tonsils for raw profit and "for the compost heaps of rich doctors’ organic gardens"?
Seriously though... Remarks such as these from Obama, I think, demonstrates two aspects of his character. First, it shows clearly Obama's naivete and arrogance as he suggests something so foolish, unresearched, and off-the-wall, but can still say it with such conviction and authority on a national, if not international, stage.
Secondly, it shows what a low opinion Obama has of other human beings. After all, he's suggesting that a highly trained, highly intelligent medical professional will intentionally allow an innocent patient, another human being, to suffer needlessly and then cripple him/her with an amputation for the made-up figure of $30 - $50,000. Does his line of thinking seem reasonable to anyone else?
Naivete, arrogance, and a despising of your fellow man... Is this a great combination for a president or what?
(Do you think we should report Obama's fishy comments to flag@whitehouse.gov?)
Thursday, August 13, 2009
Senate Health Care Bill Blues: Take Action and BE HEARD
Yeah... no doubt about it. I picked the wrong summer to write this novel (my third). I've had to put it aside. I can't stand by and not devote my attention to this health care debate. Aside from the mudslinging, the SEIU violence, Pelosi's (after accusing dissenters of being nazis) questioning of the patriotism of dissenters, and other assorted nonsense, the health care bill is a vitally important issue.
It is in the best interests of all people who value their freedom of choice, and believe in a free market system of exchange, for those who do not wish live under the yoke of a British-NHS style of nationalized health care to stand up and say "no" to this bill.
Contact your Congressional Representatives and your senators. Don't e-mail them (it's stated that it'll takes 6 - 8 weeks to get a reply). Call them at their offices. Be polite. Be courteous. Respect the office. Don't yell. Don't name call. But be HEARD! Express your opinions and thoughts in no uncertain terms.
I'm still slogging through the Senate Health, Education, Labor and Pensions (HELP) Committee bill (615 pages long), but I can tell you this much. The bill retains the HBAC provision, although it's been renamed the Medical Advisory Council (Sec. 3103, pages 62 - 71) and is now subject to Congressional review, that will ration your health care, set standards (controls) for private insurers, and likely drive all non-government subsidized health insurers out of business.
I've called both of my senators, and the people I've talked to have been very polite and courteous. Don't be anxious about this. It is not just your right as an American, but your duty as an American. I quoted Theodore Roosevelt at the top of this blog and I do so again. "To announce that there must be no criticism of the president, or that we are to stand by the president, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public."
Don't let a president who makes such a ludicrous claim like this at the Portsmouth town hall determine what's best for your health care. "All I'm saying is let's take the example of something like diabetes, one of—a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family—if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000—immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money.
"So changing reimbursement rates will help. The other thing that will really help both nurses and doctors, helping pay for medical education for those who are willing to go into primary care. And that's something that we already started to do under the Recovery Act, and we want to do more of that under health care reform" (h/t No Sheeples Here and do read her informed response). This was even worse than that tonsil and red pill/blue pill nonsense.
We as a people, not just the left and right, but all of us as Americans have been lax, dispirited, and cynical for far too long. Most of us don't even bother to vote. That must end now. It's not too late. You can make a difference-- headline: "Newly elected Democrats waver on health plan" (h/t Instapundit).
It is in the best interests of all people who value their freedom of choice, and believe in a free market system of exchange, for those who do not wish live under the yoke of a British-NHS style of nationalized health care to stand up and say "no" to this bill.
Contact your Congressional Representatives and your senators. Don't e-mail them (it's stated that it'll takes 6 - 8 weeks to get a reply). Call them at their offices. Be polite. Be courteous. Respect the office. Don't yell. Don't name call. But be HEARD! Express your opinions and thoughts in no uncertain terms.
I'm still slogging through the Senate Health, Education, Labor and Pensions (HELP) Committee bill (615 pages long), but I can tell you this much. The bill retains the HBAC provision, although it's been renamed the Medical Advisory Council (Sec. 3103, pages 62 - 71) and is now subject to Congressional review, that will ration your health care, set standards (controls) for private insurers, and likely drive all non-government subsidized health insurers out of business.
I've called both of my senators, and the people I've talked to have been very polite and courteous. Don't be anxious about this. It is not just your right as an American, but your duty as an American. I quoted Theodore Roosevelt at the top of this blog and I do so again. "To announce that there must be no criticism of the president, or that we are to stand by the president, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public."
Don't let a president who makes such a ludicrous claim like this at the Portsmouth town hall determine what's best for your health care. "All I'm saying is let's take the example of something like diabetes, one of—a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family—if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000—immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money.
"So changing reimbursement rates will help. The other thing that will really help both nurses and doctors, helping pay for medical education for those who are willing to go into primary care. And that's something that we already started to do under the Recovery Act, and we want to do more of that under health care reform" (h/t No Sheeples Here and do read her informed response). This was even worse than that tonsil and red pill/blue pill nonsense.
We as a people, not just the left and right, but all of us as Americans have been lax, dispirited, and cynical for far too long. Most of us don't even bother to vote. That must end now. It's not too late. You can make a difference-- headline: "Newly elected Democrats waver on health plan" (h/t Instapundit).
Obama's Town Hall in Portsmouth-- Health Care Theater and Deception Pt.2: The HBAC-- Obama's NHS
The argument has been made that Britain's socialized health care is not a fair comparison to what's currently proposed. That's actually a pretty hard to address as the House's draft bill is 1018 pages long, the entirety of which must read, understood, and then be put into the context of economic reality, even though it is not written from that perspective. It's a daunting feat that some in Congress (as Rep. John Conyers video here) seem to freely admit that they're not up to.
However, Senator Tom Coburn (R) has written that "[b]oth the Senate and House bills set up a government-run 'comparative effectiveness' board that will make final decisions about treatment and care. In committee, I gave senators several opportunities to accept language that would forbid this board from denying care. All of my amendments were rejected, which suggests that the intent is to set up a board that will ration care, as is done in the United Kingdom."
As I have said in part one of this post, there is language in the bill that clearly sets up a government-run "comparative effectiveness" board called the Health Benefits Advisory Committee (HBAC). This is on page 30, section 123. HBAC is endowed with powers not dissimilar from the powers that Britain's National Health Services (NHS) exercises in the UK. What's more, although it seems a bit vague and convoluted, the HBAC would set standards not just for the public option, but for private insurers as well.
The structure of the HBAC itself should be enough to give most people pause. The board shall be chaired by the Surgeon General (a presidential appointee confirmed by Congress) and populated by 20 to 26 additional members. 9 of these members will be directly appointed by the president and may not be federal employees, and an additional 2-8 (even numbers only) are appointed by the president who may be federal employees. Another 9 members would be appointed by the Comptroller General of the United States (the head of the GAO and also a presidential appointee confirmed by Congress). In other words, once instituted Obama will directly appoint 17 members of the board (not including the Surgeon General) to stack against 9 appointees selected by another presidential appointee [The current Comptroller is Eugene Louis Dodaro an interim who is officially an Acting Comptroller General and will serve until another Comptroller is nominated by the president].
In other words, the initial HBAC will be stacked with Obama appointees (a minimum number of 12 and a maximum of 18 in a board of 21-27). The additional 9 members could very well be appointed by another Obama appointee if Dodaro is replaced before the passage of the bill.
What is the function of the HBAC? According to the language of the bill itself (pg. 32) "The Health Benefits Advisory Committee shall recommend to the Secretary of Health and Human Services [...] benefit standards [...], and periodic updates to such standards." In other words, they will determine what is covered and not covered by the government health plan. Not at all like the UK's NHS... right? Okay, granted they will "recommend" benefit standards to the Secretary of Health and Human Service, but what are the odds that Kathleen Sebelius won't take a recommendation from a board made up almost exclusively of Obama appointees?
So what can you expect from the HBAC? Since they're going to be Obama appointees, I would go out on a limb here and suggest that you can expect pretty much what Obama wants.
And what does Obama want? Well, though he denies it, Obama said in 2003 that he wants single-payer health insurance (video here). His words "... how do we get the federal government to take care of its business? I happen to be a proponent of single payer universal health care program." Obama can't get much clearer than that. And if he denies it now, as he seems to do, he is either lying now, lying then, or has inexplicably changed his mind and will not explain nor even acknowledge it.
Additionally the Organizing for America (OFA) website confirms this in, rather amusingly, their Fact Check section.
"Rhetoric: 'Today, he [Obama] opposes single payer health care, and attacks Sen. Clinton for proposing a plan that covers everyone'
"Reality: Obama Has Consistently Said That If We Were Starting From Scratch, He Would Support A Single Payer System, But Now We Need To Build On The System We Have."
A few paragraphs down: "If Obama Were Starting From Scratch, He Would Support A Single Payer System. Obama said, 'Here's the bottom line. If I were designing a system from scratch I would probably set up a single-payer system...But we're not designing a system from scratch...And when we had a healthcare forum before I set up my healthcare plan here in Iowa there was a lot of resistance to a single-payer system. So what I believe is we should set up a series of choices....Over time it may be that we end up transitioning to such a system. For now, I just want to make sure every American is covered...I don't want to wait for that perfect system...'[emphasis mine]."
So just to recap, the House bill establishes the HBAC, a board the majority of which are handpicked by the president, whose duties are to determine what is covered and not covered by the federal government's health insurance plan. Obama himself has admitted he is a proponent of a single-payer health plan. Do you think he will appoint people who are not? Do you think that they will not structure an expensive (in tax dollars), but initially attractive plan to best bring about a single-payer system in the short-term? It would be good to remember that Britain's NHS was "the envy of Europe" after its initial inception.
During the Portsmouth town hall Obama goes on to suggest that private health care providers can compete with government insurance (video here & transcript of Portsmouth Town Hall here). He uses the UPS and FedEx as examples of private companies successfully competing against the federal government. His words: "'Now, I recognize, though, you make a legitimate -- you raise a legitimate concern. People say, well, how can a private company compete against the government? And my answer is that if the private insurance companies are providing a good bargain, and if the public option has to be self-sustaining -- meaning taxpayers aren't subsidizing it, but it has to run on charging premiums and providing good services and a good network of doctors, just like any other private insurer would do -- then I think private insurers should be able to compete. They do it all the time.' (Applause.)
"I mean, if you think about -- if you think about it, UPS and FedEx are doing just fine, right? No, they are. It's the Post Office that's always having problems."
Well, aside from the perhaps inadvertent suggestion that government entities such as the Post Office are in financial trouble (they are... the Post Office stands to lose $7 billion this year), this comparison is absolute nonsense. The federal government does not regulate mail to nearly the same extent that it regulates the health industry even currently, nor is the Post Office propped up by a fervent public demand (as a government run health insurance plan surely would be). Rory Cooper at the The Foundry asks an interesting question. "If Americans were offered 'free' postage paid for by massive government spending and tax hikes, would Fedex and UPS still exist?" Not likely.
But private insurance groups will not be competing against the Post Office. They will be competing against the federal government and the public health plan currently being constructed from the House bill -- and that bill tilts the table heavily in favor of the public option.
As I stated before, it appears that the HBAC would be able to set standards that private insurance providers must abide by (stacking the deck with over-regulation don't you think?).
Additionally:
Businesses that currently provide private health insurance would be taxed which would encourage them to take up the public option-- I mean they're paying for it anyway... (page 149): "A contribution [tax] is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution (1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and (2) shall be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employer is enrolled."
An excise tax would be levied against all goods from businesses who do not offer health insurance in accordance to government (HBAC?) mandates (page 110): "Excise tax on failures to meet certain health coverage requirements--"
People who opt out of health insurance would be taxed (page 167): "TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent (1) the taxpayer's modified adjusted gross income for the taxable year over (2) the amount of gross income specified in the section 6012(a) (1) with respect to the taxpayer."
No company nor individual may sue for price regulation, i.e. a government monopoly's price fixing (page 124): "There shall be no administrative nor judicial review of a payment rate or methodology established under this section or under section 224."
The Treasury will cover costs of the public option (page 110): "Appropriations to cover government contributions-- There are hereby appropriated, out of the moneys in the Treasury not otherwise appropriated, to the Trust Fund, an amount equivalent to the to the amount of payments made from the Trust Fund under subsection (b) plus such amounts as are necessary reduced by the amounts deposited under paragraph (1)."
So in summary, Obama suggests that a private company should be able to compete with a public option which is: a) already forcibly paid for by its potential customers whether they want it or not, b) sets the regulations for standards of care (what is and what is not covered) and controls the size of the payments for medical services, and c) is subsidized through government money (taxes) and will not be allowed to fold. Yeah... That's an even playing field...
No. The point of this bill seems to be two-fold. First, to impose strict government regulation on the medical industry and private insurance providers (fundamentally telling them how to run their businesses and most likely driving them to insolvency or just straight out of business). Secondly to impose a government standard of health insurance on all individuals. Being sustainable or affordable does not seem to be a priority in this bill, neither is allowing for an individual's choosing of their own health care.
So when Obama trumpets his famous words (video here), as he did at the AARP-- who have not endorsed the reform, despite Obama's claim-- "If you have insurance that you like, you will be able to keep that insurance. If you've got a doctor that you like, you will be able to keep your doctor. Nobody is trying to change what works in the system. We are trying to change what doesn't work in the system." Obama's lying. He can't possibly make that assurance. At best, Obama would have absolutely no idea whatsoever if your current insurance and their doctor can remain viable in this new and highly regulated environment. At worst, Obama knows the intent of this bill, to impose NHS style health care, and he is simply lying about it.
More in Part 3 UPDATE: My next long post will also be on health care, but will most likely not be about the Portsmouth Townhall.
However, Senator Tom Coburn (R) has written that "[b]oth the Senate and House bills set up a government-run 'comparative effectiveness' board that will make final decisions about treatment and care. In committee, I gave senators several opportunities to accept language that would forbid this board from denying care. All of my amendments were rejected, which suggests that the intent is to set up a board that will ration care, as is done in the United Kingdom."
As I have said in part one of this post, there is language in the bill that clearly sets up a government-run "comparative effectiveness" board called the Health Benefits Advisory Committee (HBAC). This is on page 30, section 123. HBAC is endowed with powers not dissimilar from the powers that Britain's National Health Services (NHS) exercises in the UK. What's more, although it seems a bit vague and convoluted, the HBAC would set standards not just for the public option, but for private insurers as well.
The structure of the HBAC itself should be enough to give most people pause. The board shall be chaired by the Surgeon General (a presidential appointee confirmed by Congress) and populated by 20 to 26 additional members. 9 of these members will be directly appointed by the president and may not be federal employees, and an additional 2-8 (even numbers only) are appointed by the president who may be federal employees. Another 9 members would be appointed by the Comptroller General of the United States (the head of the GAO and also a presidential appointee confirmed by Congress). In other words, once instituted Obama will directly appoint 17 members of the board (not including the Surgeon General) to stack against 9 appointees selected by another presidential appointee [The current Comptroller is Eugene Louis Dodaro an interim who is officially an Acting Comptroller General and will serve until another Comptroller is nominated by the president].
In other words, the initial HBAC will be stacked with Obama appointees (a minimum number of 12 and a maximum of 18 in a board of 21-27). The additional 9 members could very well be appointed by another Obama appointee if Dodaro is replaced before the passage of the bill.
What is the function of the HBAC? According to the language of the bill itself (pg. 32) "The Health Benefits Advisory Committee shall recommend to the Secretary of Health and Human Services [...] benefit standards [...], and periodic updates to such standards." In other words, they will determine what is covered and not covered by the government health plan. Not at all like the UK's NHS... right? Okay, granted they will "recommend" benefit standards to the Secretary of Health and Human Service, but what are the odds that Kathleen Sebelius won't take a recommendation from a board made up almost exclusively of Obama appointees?
So what can you expect from the HBAC? Since they're going to be Obama appointees, I would go out on a limb here and suggest that you can expect pretty much what Obama wants.
And what does Obama want? Well, though he denies it, Obama said in 2003 that he wants single-payer health insurance (video here). His words "... how do we get the federal government to take care of its business? I happen to be a proponent of single payer universal health care program." Obama can't get much clearer than that. And if he denies it now, as he seems to do, he is either lying now, lying then, or has inexplicably changed his mind and will not explain nor even acknowledge it.
Additionally the Organizing for America (OFA) website confirms this in, rather amusingly, their Fact Check section.
"Rhetoric: 'Today, he [Obama] opposes single payer health care, and attacks Sen. Clinton for proposing a plan that covers everyone'
"Reality: Obama Has Consistently Said That If We Were Starting From Scratch, He Would Support A Single Payer System, But Now We Need To Build On The System We Have."
A few paragraphs down: "If Obama Were Starting From Scratch, He Would Support A Single Payer System. Obama said, 'Here's the bottom line. If I were designing a system from scratch I would probably set up a single-payer system...But we're not designing a system from scratch...And when we had a healthcare forum before I set up my healthcare plan here in Iowa there was a lot of resistance to a single-payer system. So what I believe is we should set up a series of choices....Over time it may be that we end up transitioning to such a system. For now, I just want to make sure every American is covered...I don't want to wait for that perfect system...'[emphasis mine]."
So just to recap, the House bill establishes the HBAC, a board the majority of which are handpicked by the president, whose duties are to determine what is covered and not covered by the federal government's health insurance plan. Obama himself has admitted he is a proponent of a single-payer health plan. Do you think he will appoint people who are not? Do you think that they will not structure an expensive (in tax dollars), but initially attractive plan to best bring about a single-payer system in the short-term? It would be good to remember that Britain's NHS was "the envy of Europe" after its initial inception.
During the Portsmouth town hall Obama goes on to suggest that private health care providers can compete with government insurance (video here & transcript of Portsmouth Town Hall here). He uses the UPS and FedEx as examples of private companies successfully competing against the federal government. His words: "'Now, I recognize, though, you make a legitimate -- you raise a legitimate concern. People say, well, how can a private company compete against the government? And my answer is that if the private insurance companies are providing a good bargain, and if the public option has to be self-sustaining -- meaning taxpayers aren't subsidizing it, but it has to run on charging premiums and providing good services and a good network of doctors, just like any other private insurer would do -- then I think private insurers should be able to compete. They do it all the time.' (Applause.)
"I mean, if you think about -- if you think about it, UPS and FedEx are doing just fine, right? No, they are. It's the Post Office that's always having problems."
Well, aside from the perhaps inadvertent suggestion that government entities such as the Post Office are in financial trouble (they are... the Post Office stands to lose $7 billion this year), this comparison is absolute nonsense. The federal government does not regulate mail to nearly the same extent that it regulates the health industry even currently, nor is the Post Office propped up by a fervent public demand (as a government run health insurance plan surely would be). Rory Cooper at the The Foundry asks an interesting question. "If Americans were offered 'free' postage paid for by massive government spending and tax hikes, would Fedex and UPS still exist?" Not likely.
But private insurance groups will not be competing against the Post Office. They will be competing against the federal government and the public health plan currently being constructed from the House bill -- and that bill tilts the table heavily in favor of the public option.
As I stated before, it appears that the HBAC would be able to set standards that private insurance providers must abide by (stacking the deck with over-regulation don't you think?).
Additionally:
Businesses that currently provide private health insurance would be taxed which would encourage them to take up the public option-- I mean they're paying for it anyway... (page 149): "A contribution [tax] is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution (1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and (2) shall be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employer is enrolled."
An excise tax would be levied against all goods from businesses who do not offer health insurance in accordance to government (HBAC?) mandates (page 110): "Excise tax on failures to meet certain health coverage requirements--"
People who opt out of health insurance would be taxed (page 167): "TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent (1) the taxpayer's modified adjusted gross income for the taxable year over (2) the amount of gross income specified in the section 6012(a) (1) with respect to the taxpayer."
No company nor individual may sue for price regulation, i.e. a government monopoly's price fixing (page 124): "There shall be no administrative nor judicial review of a payment rate or methodology established under this section or under section 224."
The Treasury will cover costs of the public option (page 110): "Appropriations to cover government contributions-- There are hereby appropriated, out of the moneys in the Treasury not otherwise appropriated, to the Trust Fund, an amount equivalent to the to the amount of payments made from the Trust Fund under subsection (b) plus such amounts as are necessary reduced by the amounts deposited under paragraph (1)."
So in summary, Obama suggests that a private company should be able to compete with a public option which is: a) already forcibly paid for by its potential customers whether they want it or not, b) sets the regulations for standards of care (what is and what is not covered) and controls the size of the payments for medical services, and c) is subsidized through government money (taxes) and will not be allowed to fold. Yeah... That's an even playing field...
No. The point of this bill seems to be two-fold. First, to impose strict government regulation on the medical industry and private insurance providers (fundamentally telling them how to run their businesses and most likely driving them to insolvency or just straight out of business). Secondly to impose a government standard of health insurance on all individuals. Being sustainable or affordable does not seem to be a priority in this bill, neither is allowing for an individual's choosing of their own health care.
So when Obama trumpets his famous words (video here), as he did at the AARP-- who have not endorsed the reform, despite Obama's claim-- "If you have insurance that you like, you will be able to keep that insurance. If you've got a doctor that you like, you will be able to keep your doctor. Nobody is trying to change what works in the system. We are trying to change what doesn't work in the system." Obama's lying. He can't possibly make that assurance. At best, Obama would have absolutely no idea whatsoever if your current insurance and their doctor can remain viable in this new and highly regulated environment. At worst, Obama knows the intent of this bill, to impose NHS style health care, and he is simply lying about it.
More in Part 3 UPDATE: My next long post will also be on health care, but will most likely not be about the Portsmouth Townhall.
Wednesday, August 12, 2009
Obama's Town Hall in Portsmouth-- Health Care Theater and Deception Pt.1: Obama Dismisses "Death Panels"
I just can't get enough of these "unstaged" town hall meetings. The crowd ended the event by chanting "Yes, we can!" Huh... That's not suspicious at all, even when considering the fact that a majority of Americans are queasy about the nebulous health care reform proposals (check out the Rasmussen survey in the link-- there are some very interesting numbers in the report) and Obama's approval rating is currently at -7 also according to Rasmussen.
Despite his previous, folksy admonishment that any opposition should just shut up and let him do his work (Obama's words: "I don't want the folks who created the mess to do a lot of talkin'; I want them to get outta the way so I can clean up the mess. I don't mind cleanin' up after 'em, but don't do a lot of talkin'!"), Obama actually had the temerity to pantomime trying to find a questioner to challenge him during the town hall. Perhaps the critics were afraid they would be "punch[ed] back twice as hard," as deputy chief of staff Jim Messina told Democratic senators-- words that some SEIU staffers seem to be taking quite literally. No, the "un-American" mobs that have been villified as nazis (Pelosi's quote: "They're carrying swastikas and symbols like that to a town meeting on health care.") and "political terrorists" threatening both political stability and the American way of life, were nowhere to be seen during Obama's Portsmouth town hall.
They were there in a way. They were outside waving placards, examples of what a 13-year-old girl Obama happened to call upon described as "mean signs." [UPDATE: SURPRISE! Via the Boston Globe-- she's actually an 11-year-old girl named Julia Hall (she did an interview with the Globe and freely gave her name so I repeat here) and a her mother has political ties to Obama. From the article: "Julia's mother was an early Obama supporter in Massachusetts during the presidential election, so she had previously met First Lady Michelle Obama, the Obama daughters Sasha and Malia, and Vice President Joe Biden." Michelle Malkin has more here including a facebook picture of mother and Obama standing side by side. "Manning Hall (Julia's mother Kathleen) has donated thousands of dollars to Obama, as has her law firm." Kind of "surprising" that the girl didn't give Obama the "vigorous debate" he was "bracing" for, isn't it? Hope and Change --and a maybe a few happy "coincidences" along the way...] I have to admit that I died a little inside when this same girl intoned "How do kids know what’s true?" Obama's manipulative strategy of hiding behind frightened children in downright shameful. [Even more so now.]
If Obama really wanted "a vigorous debate" as he implied while in Mexico, all he had to do was step out of the town hall's front door. But participants who have not been pre-screened nor hand-picked by the White House can be politically dangerous. Even a softball question from a Chicago reporter can derail Obama when he's working from scripted talking points, as Gates-gate demonstrated.
No critical questions for Obama? Anyone? Anyone? Bueller?
One of my favorite moments is when Obama claimed that "nearly 56 million Americans" are uninsured. That surprised me a little because the number that's usually bandied about is the grossly exaggerated and deceptive 47 million. This is a figure that floats around in certain left-leaning circles and was famously invoked in Michael Moore's movie "Sicko." So have 9 million more Americans suddenly lost their insurance since Obama has taken office? Well, I'm sure it's Bush's fault... or something.
Yet, even the 47 million figure is actually nonsense when the numbers are broken down, as Julia A. Seymour demonstrates. "The Census Bureau's 2007 report on the uninsured found that of the 45.6 million people who are uninsured 9.7 million of them are non-citizens, 7.9 million of them are under 24 years old, and over 9 million could afford insurance because they make at least $75,000 a year. That leaves roughly 19 million uninsured, a much smaller problem than the media and some politicians admit [slightly over 6% of the population]." 19 million uninsured Americans is not "nearly 56 million Americans." And one has to ask why are they not covered by Medicaid... I mean aside from the fact, that one wouldn't want to be?
Another notable town hall moment is when Obama responded to the 13-year-old girl's [11 year-old girl's per UPDATE] question. Dismissing the idea that the house bill contains "death panels" Obama stated "The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that it’s too expensive to let her live anymore."
While it is indeed true that the House of Representatives did not vote for euthanasia, they did vote on language that includes government oversight and bureaucratic approval of costs and treatments (section 123-pg. 30, see also Senator Coburn's question #6) , as well as counseling for end-of-life care (section 1233). These are plainly contained within the House's measure There is no debate on this. The only question is what the results of such oversight and counseling will be. And the track record of other countries institutionalizing socialized medicine isn't very good.
In Great Britain, where the NHS (National Health Service) oversees the costs and runs socialized health care the results have been horrific. In a piece on health care that I posted back in April, I listed some of the results of the NHS's machinations. Such examples include the infamous "hospital of death" in which occured "between 400 and 1,200 more deaths than the national average in the three years to 2007-08" amidst appalling conditions. Another example of the NHS's draconian work is the decision that "[a]n ex-serviceman is left to go blind in one eye before the National Health Service will consider treating him for a condition affecting 250,000 people in the UK."
Britain's National Institute of Health and Clinical Excellence (NICE-- a rather misleading acronym) has refused to offer some drugs to NHS kidney cancer patients because of cost. "It concluded that the drugs - bevacizumab, sorafenib, sunitinib and temsirolimus - did not offer value for money [bang for the buck in American bailout jargon]." This prompted some of the "UK's top cancer consultants warn that NHS drug 'rationing' is forcing patients to remortgage their homes to pay for treatment."
NICE offers neither excuses nor apologies, but at least they don't bandy words. "Andrew Dillon, the NICE chief executive, and Sir Michael Rawlins, NICE's chairman, told the Sunday Times the NHS did not have unlimited funds to provide all available treatments.
"'There is a finite pot of money for the NHS, which is determined annually by parliament,' they said."'If one group of patients is provided with cost-ineffective care, other groups - lacking powerful lobbyists - will be denied cost-effective care for miserable conditions like schizophrenia, Crohn's disease or cystic fibrosis.'" Yikes.
Furthermore, NICE also has banned life prolonging cancer drugs due to cost. "Thousands of patients with terminal cancer were dealt a blow last night after a decision was made to deny them life prolonging drugs.
"The Government's rationing body said two drugs for advanced breast cancer and a rare form of stomach cancer were too expensive for the NHS."
Do you think any members of Britain's Parliament voted to "pull the plug on grandma because we’ve decided that it’s too expensive to let her live anymore?" Do you think any of them voted to let terminal cancer patients die sooner because it's too expensive to keep them alive? Those few, if any, voting MPs still alive (the NHS came into effect in 1948) can wash their hands of the matter. They never voted for anything like this... but that's what their health system is doing. The NHS is literally allowing people to die for the sake of cost effectiveness, and when its the national government, there is no possible earthly appeal.
These example of the NHS's problems are not isolated incidences, but rather are painful and tragic symptoms of a failed and ill-conceived system. More recent headlines from British papers include (h/t Michele Malkin):
Elderly left at risk by NHS bidding wars to find cheapest care with reverse auctions
Patients forced to live in agony after NHS refuses to pay for painkilling injections
Twisted priorities that let the elderly suffer
NHS neglects elderly depression a quote from this story: "Fewer than 10% of older people with clinical depression are referred to specialist mental health services compared with about 50% of younger adults with mental and emotional problems.
"In some cases, GPs are unable to refer older people on to other parts of the NHS that could help them because of discriminatory rules excluding people over the age of 65 [emphasis mine]."
Elderly suffer in care shambles: Old people living in homes are at the centre of a shameful row about benefit rules. Margaret Hughes and Phillip Inman report on the pain and who is paying the price
NHS failure on Down's screening kills healthy babies a quote from this article: "Scores of healthy foetuses die every year because most hospitals do not give pregnant women what the NHS says is the best test for Down's syndrome.
"In an interview with the Guardian, Dr Anne Mackie, the head of NHS screening programmes, estimated 146 babies a year in England who do not have any abnormality are lost as a result of efforts to detect children with the genetic condition.
"The death rate is higher than it should be because only one in three hospitals offer mothers-to-be the so-called combined test for Down's syndrome, Mackie said. It is the most accurate of the four methods the NHS uses to calculate a woman's chances of having a child with Down's. If every hospital provided the combined test, the total of what she called 'normal babies lost' would be around 90."
'I said to the nurse, please feed her': Pauline Pringle's mother went into hospital for a hip operation and came out close to starvation. And as Blake Morrison reports, hers is not an isolated case
The beginning of this article:
"Last year, my mother-in-law fell off her Stannah and broke a hip. If that sounds like the cue for a Les Dawson joke ('I was hoping it would be her neck'), it isn't: I'm fond of my mother-in-law and the result of her little accident, not funny in the least, was that she nearly died. After a belated but successful operation, she developed c diff (clostridium difficile, the nation's favourite hospital killer bug after MRSA), and three courses of antibiotics failed to clear the infection.
"Suddenly a robust, cheerful woman of 79, whose only mobility problem had been climbing stairs, began to talk of never leaving hospital again but of being 'laid out on a marble slab' - and when the hospital asked for our permission not to resuscitate her should she lose consciousness, we realised this was no paranoid fantasy.
"Thanks to the efforts of her five children, who travelled long distances to see her, brought food, pleaded with staff not to write her off and eventually - because the pleas were falling on deaf ears - moved her to another (I'm afraid, private) hospital, my mother-in-law is still around, less active than she used to be, but alive to see in another new year. She was lucky. We were lucky. But as I'm beginning to discover, many people with elderly relatives are not."
These are just a sampling of the sort of care administered by the tender mercies of government bureaucracy and centralized rationing. There are more. Look through some of Britain's papers such as the Telegraph, The Guardian, The Independent, etc. They're not hard to find.
The elderly, the infirm, the chronically ill, those who some say place a strain on the system are those that will actually suffer the most. Obama won't. He's constantly telling us that he's got a personal doctor and the best health care in the world-- it's not about him. (Did he think that line would be in any way reassuring?) It's a simple fact that those who need help the most are those who most acutely feel its lack, as they are denied the expensive tests for diagnosis and the costly treatments-- all in the name of social justice and the greater good.
This level of care was not the intention of the Parliament in 1948. Let me state, once again, that nobody in Parliament ever said that they voted for a system that would deny expensive medications to terminally ill cancer patients, nor deny cancer treatments because of cost-effectiveness, nor deny treatments based on special interest lobbies. Obama can derisively dismiss "death panels" (an unfortunate hyperbole-- "comparative effectiveness committees" is a less emotional phrase) and claim that nobody in the House voted to "pull the plug on grandma," but Britain's NHS is quite literally deciding who is treated and who is denied coverage, and, at times, who lives and who dies according to their governmental budgets.
Does Britain offer much hope for the quality of "universal health care" in this country? Is there any reason that Britain should be discounted? Is the US government inherently more compassionate and caring then Great Britain's? Since we're dealing with the cold realities of politics and economics, does it matter?
The difficulties and tragedies that Britain is dealing with are all but inevitable when dealing with a governmental provider. Medicaid, Medicare and veteran's hospitals attest to the US national government's inherent "compassion" and skill in handling health care. Is there any reason that that these enormous and floundering programs are not being mentioned by the House health care bill proponents?
The end-of-life counseling is just the icing on the cake. As health care costs continue to escalate (why would they not?), can one imagine what these "counseling" sessions would be like?
End-of-life care is some of the most expensive care. A government program burdened by crippling costs and looking to save money will send out someone to counsel elderly and infirm patients on their "options." To me, this is not unlike the NHS counseling women to abort their Down Syndrome children.
From the article: "Yesterday the BBC News website ran a selection of comments on this issue by members of the public. One in particular, by Heather of Livingston, Scotland, is worth reproducing in full here: “I was told that my daughter had Down’s when I was about 12 weeks pregnant and every doctor, gynaecologist I saw tried to convince me a termination was the best option. I was still offered this at 26 weeks! One reason given to me by a cold-hearted consultant was that ‘these babies put a strain on the NHS’. My daughter was stillborn and when pregnant again, I refused all tests apart from a scan. It’s not society who are looking for the ‘perfect baby’, it’s the medical profession [emphasis mine].""
Aside from such crude prodding to decide upon a most personal matter, the very structure of this counseling will very well be suspect. Wesley J. Smith wrote an excellent piece on how subtle strategies can be employed to structure counseling sessions into being more persuasive. I strongly suggest reading the short piece in its entirety.
Others have expressed misgivings about such counseling provisions. Eugene Robinson of the Washington Post has written: "If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending."
Charles Lane also of the Washington Post writes: "Patients may refuse without penalty, but many will bow to white-coated authority. Once they're in the meeting, the bill does permit 'formulation' of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would 'place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,' I don't think he's being realistic.
"What's more, Section 1233 dictates, at some length, the content of the consultation. The doctor 'shall' discuss 'advanced care planning, including key questions and considerations, important steps, and suggested people to talk to'; 'an explanation of . . . living wills and durable powers of attorney, and their uses' (even though these are legal, not medical, instruments); and 'a list of national and State-specific resources to assist consumers and their families.' The doctor 'shall' explain that Medicare pays for hospice care (hint, hint)." (h/t to Pundit & Pundette)
Will this counseling be one more Orwellian cost-saving measure? Why would it not? What forces, what checks, would stop it from becoming something out of Kafka or Joseph Heller's work?
Obama can dismiss all this unsavory talk of "death panels." The House of Representatives didn't vote for anything like that. Well, at least not exactly they're talking about "comparative effectiveness" committees. I suggest you look to Great Britain. Sixty years of socialized medicine, which began as "the envy of Europe" has resulted into this debacle where life and death decisions are made by a fiscally strapped NHS desperate to save costs, and not patients and patients' doctors. This did not happen by accident, nor did it happen by design. Yet it occured, and could very well be an inevitable consequence of socialized medicine and their "comparative effectiveness" commitees. Obama's dismissal of this, indeed his refusal to seriously address the issue, is both foolish and naive.
More in Part 2.
Despite his previous, folksy admonishment that any opposition should just shut up and let him do his work (Obama's words: "I don't want the folks who created the mess to do a lot of talkin'; I want them to get outta the way so I can clean up the mess. I don't mind cleanin' up after 'em, but don't do a lot of talkin'!"), Obama actually had the temerity to pantomime trying to find a questioner to challenge him during the town hall. Perhaps the critics were afraid they would be "punch[ed] back twice as hard," as deputy chief of staff Jim Messina told Democratic senators-- words that some SEIU staffers seem to be taking quite literally. No, the "un-American" mobs that have been villified as nazis (Pelosi's quote: "They're carrying swastikas and symbols like that to a town meeting on health care.") and "political terrorists" threatening both political stability and the American way of life, were nowhere to be seen during Obama's Portsmouth town hall.
They were there in a way. They were outside waving placards, examples of what a 13-year-old girl Obama happened to call upon described as "mean signs." [UPDATE: SURPRISE! Via the Boston Globe-- she's actually an 11-year-old girl named Julia Hall (she did an interview with the Globe and freely gave her name so I repeat here) and a her mother has political ties to Obama. From the article: "Julia's mother was an early Obama supporter in Massachusetts during the presidential election, so she had previously met First Lady Michelle Obama, the Obama daughters Sasha and Malia, and Vice President Joe Biden." Michelle Malkin has more here including a facebook picture of mother and Obama standing side by side. "Manning Hall (Julia's mother Kathleen) has donated thousands of dollars to Obama, as has her law firm." Kind of "surprising" that the girl didn't give Obama the "vigorous debate" he was "bracing" for, isn't it? Hope and Change --and a maybe a few happy "coincidences" along the way...] I have to admit that I died a little inside when this same girl intoned "How do kids know what’s true?" Obama's manipulative strategy of hiding behind frightened children in downright shameful. [Even more so now.]
If Obama really wanted "a vigorous debate" as he implied while in Mexico, all he had to do was step out of the town hall's front door. But participants who have not been pre-screened nor hand-picked by the White House can be politically dangerous. Even a softball question from a Chicago reporter can derail Obama when he's working from scripted talking points, as Gates-gate demonstrated.
No critical questions for Obama? Anyone? Anyone? Bueller?
One of my favorite moments is when Obama claimed that "nearly 56 million Americans" are uninsured. That surprised me a little because the number that's usually bandied about is the grossly exaggerated and deceptive 47 million. This is a figure that floats around in certain left-leaning circles and was famously invoked in Michael Moore's movie "Sicko." So have 9 million more Americans suddenly lost their insurance since Obama has taken office? Well, I'm sure it's Bush's fault... or something.
Yet, even the 47 million figure is actually nonsense when the numbers are broken down, as Julia A. Seymour demonstrates. "The Census Bureau's 2007 report on the uninsured found that of the 45.6 million people who are uninsured 9.7 million of them are non-citizens, 7.9 million of them are under 24 years old, and over 9 million could afford insurance because they make at least $75,000 a year. That leaves roughly 19 million uninsured, a much smaller problem than the media and some politicians admit [slightly over 6% of the population]." 19 million uninsured Americans is not "nearly 56 million Americans." And one has to ask why are they not covered by Medicaid... I mean aside from the fact, that one wouldn't want to be?
Another notable town hall moment is when Obama responded to the 13-year-old girl's [11 year-old girl's per UPDATE] question. Dismissing the idea that the house bill contains "death panels" Obama stated "The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that it’s too expensive to let her live anymore."
While it is indeed true that the House of Representatives did not vote for euthanasia, they did vote on language that includes government oversight and bureaucratic approval of costs and treatments (section 123-pg. 30, see also Senator Coburn's question #6) , as well as counseling for end-of-life care (section 1233). These are plainly contained within the House's measure There is no debate on this. The only question is what the results of such oversight and counseling will be. And the track record of other countries institutionalizing socialized medicine isn't very good.
In Great Britain, where the NHS (National Health Service) oversees the costs and runs socialized health care the results have been horrific. In a piece on health care that I posted back in April, I listed some of the results of the NHS's machinations. Such examples include the infamous "hospital of death" in which occured "between 400 and 1,200 more deaths than the national average in the three years to 2007-08" amidst appalling conditions. Another example of the NHS's draconian work is the decision that "[a]n ex-serviceman is left to go blind in one eye before the National Health Service will consider treating him for a condition affecting 250,000 people in the UK."
Britain's National Institute of Health and Clinical Excellence (NICE-- a rather misleading acronym) has refused to offer some drugs to NHS kidney cancer patients because of cost. "It concluded that the drugs - bevacizumab, sorafenib, sunitinib and temsirolimus - did not offer value for money [bang for the buck in American bailout jargon]." This prompted some of the "UK's top cancer consultants warn that NHS drug 'rationing' is forcing patients to remortgage their homes to pay for treatment."
NICE offers neither excuses nor apologies, but at least they don't bandy words. "Andrew Dillon, the NICE chief executive, and Sir Michael Rawlins, NICE's chairman, told the Sunday Times the NHS did not have unlimited funds to provide all available treatments.
"'There is a finite pot of money for the NHS, which is determined annually by parliament,' they said."'If one group of patients is provided with cost-ineffective care, other groups - lacking powerful lobbyists - will be denied cost-effective care for miserable conditions like schizophrenia, Crohn's disease or cystic fibrosis.'" Yikes.
Furthermore, NICE also has banned life prolonging cancer drugs due to cost. "Thousands of patients with terminal cancer were dealt a blow last night after a decision was made to deny them life prolonging drugs.
"The Government's rationing body said two drugs for advanced breast cancer and a rare form of stomach cancer were too expensive for the NHS."
Do you think any members of Britain's Parliament voted to "pull the plug on grandma because we’ve decided that it’s too expensive to let her live anymore?" Do you think any of them voted to let terminal cancer patients die sooner because it's too expensive to keep them alive? Those few, if any, voting MPs still alive (the NHS came into effect in 1948) can wash their hands of the matter. They never voted for anything like this... but that's what their health system is doing. The NHS is literally allowing people to die for the sake of cost effectiveness, and when its the national government, there is no possible earthly appeal.
These example of the NHS's problems are not isolated incidences, but rather are painful and tragic symptoms of a failed and ill-conceived system. More recent headlines from British papers include (h/t Michele Malkin):
Elderly left at risk by NHS bidding wars to find cheapest care with reverse auctions
Patients forced to live in agony after NHS refuses to pay for painkilling injections
Twisted priorities that let the elderly suffer
NHS neglects elderly depression a quote from this story: "Fewer than 10% of older people with clinical depression are referred to specialist mental health services compared with about 50% of younger adults with mental and emotional problems.
"In some cases, GPs are unable to refer older people on to other parts of the NHS that could help them because of discriminatory rules excluding people over the age of 65 [emphasis mine]."
Elderly suffer in care shambles: Old people living in homes are at the centre of a shameful row about benefit rules. Margaret Hughes and Phillip Inman report on the pain and who is paying the price
NHS failure on Down's screening kills healthy babies a quote from this article: "Scores of healthy foetuses die every year because most hospitals do not give pregnant women what the NHS says is the best test for Down's syndrome.
"In an interview with the Guardian, Dr Anne Mackie, the head of NHS screening programmes, estimated 146 babies a year in England who do not have any abnormality are lost as a result of efforts to detect children with the genetic condition.
"The death rate is higher than it should be because only one in three hospitals offer mothers-to-be the so-called combined test for Down's syndrome, Mackie said. It is the most accurate of the four methods the NHS uses to calculate a woman's chances of having a child with Down's. If every hospital provided the combined test, the total of what she called 'normal babies lost' would be around 90."
'I said to the nurse, please feed her': Pauline Pringle's mother went into hospital for a hip operation and came out close to starvation. And as Blake Morrison reports, hers is not an isolated case
The beginning of this article:
"Last year, my mother-in-law fell off her Stannah and broke a hip. If that sounds like the cue for a Les Dawson joke ('I was hoping it would be her neck'), it isn't: I'm fond of my mother-in-law and the result of her little accident, not funny in the least, was that she nearly died. After a belated but successful operation, she developed c diff (clostridium difficile, the nation's favourite hospital killer bug after MRSA), and three courses of antibiotics failed to clear the infection.
"Suddenly a robust, cheerful woman of 79, whose only mobility problem had been climbing stairs, began to talk of never leaving hospital again but of being 'laid out on a marble slab' - and when the hospital asked for our permission not to resuscitate her should she lose consciousness, we realised this was no paranoid fantasy.
"Thanks to the efforts of her five children, who travelled long distances to see her, brought food, pleaded with staff not to write her off and eventually - because the pleas were falling on deaf ears - moved her to another (I'm afraid, private) hospital, my mother-in-law is still around, less active than she used to be, but alive to see in another new year. She was lucky. We were lucky. But as I'm beginning to discover, many people with elderly relatives are not."
These are just a sampling of the sort of care administered by the tender mercies of government bureaucracy and centralized rationing. There are more. Look through some of Britain's papers such as the Telegraph, The Guardian, The Independent, etc. They're not hard to find.
The elderly, the infirm, the chronically ill, those who some say place a strain on the system are those that will actually suffer the most. Obama won't. He's constantly telling us that he's got a personal doctor and the best health care in the world-- it's not about him. (Did he think that line would be in any way reassuring?) It's a simple fact that those who need help the most are those who most acutely feel its lack, as they are denied the expensive tests for diagnosis and the costly treatments-- all in the name of social justice and the greater good.
This level of care was not the intention of the Parliament in 1948. Let me state, once again, that nobody in Parliament ever said that they voted for a system that would deny expensive medications to terminally ill cancer patients, nor deny cancer treatments because of cost-effectiveness, nor deny treatments based on special interest lobbies. Obama can derisively dismiss "death panels" (an unfortunate hyperbole-- "comparative effectiveness committees" is a less emotional phrase) and claim that nobody in the House voted to "pull the plug on grandma," but Britain's NHS is quite literally deciding who is treated and who is denied coverage, and, at times, who lives and who dies according to their governmental budgets.
Does Britain offer much hope for the quality of "universal health care" in this country? Is there any reason that Britain should be discounted? Is the US government inherently more compassionate and caring then Great Britain's? Since we're dealing with the cold realities of politics and economics, does it matter?
The difficulties and tragedies that Britain is dealing with are all but inevitable when dealing with a governmental provider. Medicaid, Medicare and veteran's hospitals attest to the US national government's inherent "compassion" and skill in handling health care. Is there any reason that that these enormous and floundering programs are not being mentioned by the House health care bill proponents?
The end-of-life counseling is just the icing on the cake. As health care costs continue to escalate (why would they not?), can one imagine what these "counseling" sessions would be like?
End-of-life care is some of the most expensive care. A government program burdened by crippling costs and looking to save money will send out someone to counsel elderly and infirm patients on their "options." To me, this is not unlike the NHS counseling women to abort their Down Syndrome children.
From the article: "Yesterday the BBC News website ran a selection of comments on this issue by members of the public. One in particular, by Heather of Livingston, Scotland, is worth reproducing in full here: “I was told that my daughter had Down’s when I was about 12 weeks pregnant and every doctor, gynaecologist I saw tried to convince me a termination was the best option. I was still offered this at 26 weeks! One reason given to me by a cold-hearted consultant was that ‘these babies put a strain on the NHS’. My daughter was stillborn and when pregnant again, I refused all tests apart from a scan. It’s not society who are looking for the ‘perfect baby’, it’s the medical profession [emphasis mine].""
Aside from such crude prodding to decide upon a most personal matter, the very structure of this counseling will very well be suspect. Wesley J. Smith wrote an excellent piece on how subtle strategies can be employed to structure counseling sessions into being more persuasive. I strongly suggest reading the short piece in its entirety.
Others have expressed misgivings about such counseling provisions. Eugene Robinson of the Washington Post has written: "If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending."
Charles Lane also of the Washington Post writes: "Patients may refuse without penalty, but many will bow to white-coated authority. Once they're in the meeting, the bill does permit 'formulation' of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would 'place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,' I don't think he's being realistic.
"What's more, Section 1233 dictates, at some length, the content of the consultation. The doctor 'shall' discuss 'advanced care planning, including key questions and considerations, important steps, and suggested people to talk to'; 'an explanation of . . . living wills and durable powers of attorney, and their uses' (even though these are legal, not medical, instruments); and 'a list of national and State-specific resources to assist consumers and their families.' The doctor 'shall' explain that Medicare pays for hospice care (hint, hint)." (h/t to Pundit & Pundette)
Will this counseling be one more Orwellian cost-saving measure? Why would it not? What forces, what checks, would stop it from becoming something out of Kafka or Joseph Heller's work?
Obama can dismiss all this unsavory talk of "death panels." The House of Representatives didn't vote for anything like that. Well, at least not exactly they're talking about "comparative effectiveness" committees. I suggest you look to Great Britain. Sixty years of socialized medicine, which began as "the envy of Europe" has resulted into this debacle where life and death decisions are made by a fiscally strapped NHS desperate to save costs, and not patients and patients' doctors. This did not happen by accident, nor did it happen by design. Yet it occured, and could very well be an inevitable consequence of socialized medicine and their "comparative effectiveness" commitees. Obama's dismissal of this, indeed his refusal to seriously address the issue, is both foolish and naive.
More in Part 2.
Tuesday, August 11, 2009
Some Health Care Debate Links
I thought I'd throw out a few links regarding health care reform.
Sen. Tom Coburn has an excellent article in National Review Online titled "Ten Questions Politicians Won’t Answer." (h/t Pundit and Pundette). He offers a number of reasonable arguments against both the bills form, and the tactics used by the Congressional leadership and the White House.
Sarah Palin made a lot of headline and hit lists with her "death panels" note on facebook. Before jumping to conclusions, one should read her statement first. It is here.
Michelle Malkin has a list of some of Britain's frightening cost saving measures in a post here. She equates these, at times, draconian cost-saving measures with Palin's "death panel" statement.
Thomas Sowell has an excellent opinion piece found here regarding government and health care.
I can't stop myself from putting in a quick quote: "A bigger question is whether medical care will be better or worse after the government takes it over. There are many available facts relevant to those crucial questions but remarkably little interest in those facts.
"There are facts about the massive government-run medical programs already in existence in the United States — Medicare, Medicaid and veterans' hospitals — as well as government-run medical systems in other countries.
"None of the people who are trying to rush government-run medical care through Congress before we have time to think about it are pointing to Medicare, Medicaid or veterans' hospitals as shining examples of how wonderful we can expect government medical care to be when it becomes 'universal.'"
"As for those uninsured Americans we keep hearing about, there is remarkably little interest in why they don't have insurance. It cannot be poverty, for the poor can automatically get Medicaid.
"In fact, we already know that there are people with substantial incomes who choose to spend those incomes on other things, especially if they are young and in good health. If necessary, they can always go to a hospital emergency room and receive treatment there, whether or not they have insurance.
"Here, the advocates of government-run medical care say that we all end up paying, one way or another, for the free medical care that hospitals are forced by law to provide in their emergency rooms. But unless you think that any situation you don't like is a reason to give politicians a blank check for 'change,' the relevant question becomes whether the alternative is either less expensive or of better quality. Nothing is cheaper just because part of the price is paid in higher taxes. "
Go read the whole article though.
Thomas Sowell also has more informative editorials regarding health care here and here. All are likewise thoughtful and highly recommended.
William A. Jacobson at Legal Insurrection has several good post on various aspects of the health care debate. This post is of particular interest, however.
A quick quote: "One of the key elements of the Democratic proposals is to hand over the power to make cost cuts to an unelected, unimpeachable council similar to MedPAC. By empowering such an insular entity to make decisions over which health care procedures and medicines are cost-effective, we will have surrendered enormous freedom over personal health care. If a procedure or medication is not approved by this entity, it will not be economically viable for the provider to bring it to market, so it will not be available even if you were willing to pay out of pocket.
"Putting aside our freedom, the CBO has come out with an analysis (appearing in full below) which shows that handing over health care decisions to an entity such as MedPAC will not save any substantial sums over the next decade, even as the cost of health care 'reform' escalates."
The CBO analysis itself is available in Jacobson's post and is also linked here.
And lastly, I'll put up links to my own long post about health care reform that I wrote back in April. It's in two parts, the first part here and the second here.
I've tried to limit my links to posts and articles about health care reform from a conservative perspective, rather than items about the ugly debate that has emerged. I hope this list proves informative.
Sen. Tom Coburn has an excellent article in National Review Online titled "Ten Questions Politicians Won’t Answer." (h/t Pundit and Pundette). He offers a number of reasonable arguments against both the bills form, and the tactics used by the Congressional leadership and the White House.
Sarah Palin made a lot of headline and hit lists with her "death panels" note on facebook. Before jumping to conclusions, one should read her statement first. It is here.
Michelle Malkin has a list of some of Britain's frightening cost saving measures in a post here. She equates these, at times, draconian cost-saving measures with Palin's "death panel" statement.
Thomas Sowell has an excellent opinion piece found here regarding government and health care.
I can't stop myself from putting in a quick quote: "A bigger question is whether medical care will be better or worse after the government takes it over. There are many available facts relevant to those crucial questions but remarkably little interest in those facts.
"There are facts about the massive government-run medical programs already in existence in the United States — Medicare, Medicaid and veterans' hospitals — as well as government-run medical systems in other countries.
"None of the people who are trying to rush government-run medical care through Congress before we have time to think about it are pointing to Medicare, Medicaid or veterans' hospitals as shining examples of how wonderful we can expect government medical care to be when it becomes 'universal.'"
"As for those uninsured Americans we keep hearing about, there is remarkably little interest in why they don't have insurance. It cannot be poverty, for the poor can automatically get Medicaid.
"In fact, we already know that there are people with substantial incomes who choose to spend those incomes on other things, especially if they are young and in good health. If necessary, they can always go to a hospital emergency room and receive treatment there, whether or not they have insurance.
"Here, the advocates of government-run medical care say that we all end up paying, one way or another, for the free medical care that hospitals are forced by law to provide in their emergency rooms. But unless you think that any situation you don't like is a reason to give politicians a blank check for 'change,' the relevant question becomes whether the alternative is either less expensive or of better quality. Nothing is cheaper just because part of the price is paid in higher taxes. "
Go read the whole article though.
Thomas Sowell also has more informative editorials regarding health care here and here. All are likewise thoughtful and highly recommended.
William A. Jacobson at Legal Insurrection has several good post on various aspects of the health care debate. This post is of particular interest, however.
A quick quote: "One of the key elements of the Democratic proposals is to hand over the power to make cost cuts to an unelected, unimpeachable council similar to MedPAC. By empowering such an insular entity to make decisions over which health care procedures and medicines are cost-effective, we will have surrendered enormous freedom over personal health care. If a procedure or medication is not approved by this entity, it will not be economically viable for the provider to bring it to market, so it will not be available even if you were willing to pay out of pocket.
"Putting aside our freedom, the CBO has come out with an analysis (appearing in full below) which shows that handing over health care decisions to an entity such as MedPAC will not save any substantial sums over the next decade, even as the cost of health care 'reform' escalates."
The CBO analysis itself is available in Jacobson's post and is also linked here.
And lastly, I'll put up links to my own long post about health care reform that I wrote back in April. It's in two parts, the first part here and the second here.
I've tried to limit my links to posts and articles about health care reform from a conservative perspective, rather than items about the ugly debate that has emerged. I hope this list proves informative.
Sunday, August 9, 2009
My Favorite Health Care Debate Mob Photo
Man, did I pick the wrong summer to try to blog and write a novel at the same time. Between the White House calls for reporting "fishy" rumors about health care during a "casual conversation," (unbelievable...) and Obama's "I don't want the folks who created the mess to do a lot of talkin'" (created the health care system?) rant this week, I had to put aside my book and just observe for a short time. Honestly, I don't know whether to laugh, or to just pack up and move to Japan or Singapore.
The great unifier image of Obama has pretty much been, not merely shattered (that happened months ago), but completely forgotten. Does anybody even remember the high hopes of the "I Pledge..." Video days? My reaction to that video has become even worse... It still makes me retch, but now I actually taste the bile in my mouth. Ah...but more on that in a later post.
When I saw the photo above on Legal Insurrection, I had to laugh-- so I guess I'm staying in the US. Of course, these are the folks that Obama "doesn't want to do a lot of talkin'." The pic is from Dana Loesch's "Meet the Mob" post and there are number of amusing pics in the post. Check them out and enjoy.
I'll probably have more to say later... if I can find the words. Right now my vocabulary is failing me-- but then I won't resort to some folksy affectation like Obama. "I don't want the folks who created the mess to do a lot of talkin'. I want them to get outta the way so I can clean up the mess. I don't mind cleanin' up after 'em, but don't do a lot of talkin'." Good Lord...
Monday, August 3, 2009
Recommended Article on End-of Life Counseling
A lot of concern has been expressed (correctly in my mind) about the specter and implications of end-of-life counseling by government representatives hoping to save money.
Check out this article by Wesley J. Smith (h/t Pundit and Pundette) regarding the issue. It's a short piece and be sure to check out the comments especially the first one. Here's a sample from the article, but I highly recommend people to read the whole thing.
"The Medicare 'mandatory counseling' controversy in the Obamacare debate laid bare a realistic fear that compensated counseling under Medicare could easily become subtle (or not so subtle) persuasion to refuse treatment–particularly since the primary point of the clause is to cut costs.
"Here is an example of why I believe that the fear is realistic. The Center for Practical Bioethics has published a 'Caring Conversations' workbook, in which intimate issues and details of life, death, and end of life options are raised. Nothing wrong with that, in and of itself, of course. It all depends on how it is done."
The problem with counseling sessions is that they almost always end up being persuasion sessions. For the counseled, it really comes down to being a matter of trust. Does the counseled trust the persuasion to be with their best interests in mind? A person generally trusts their family doctor to be looking out for their best interests , or at least they should, (as in if they don't then they need to find another doctor that they do trust). However, when counselors, trained to be appear trustworthy, armed with cleverly written and persuasive workbooks, enter with the full weight of federal authority behind them... Well, you get the picture, and it's not pretty.
Yes, of course it is true that private insurers are driven to make money. However, they are subject to various market forces (such as consumer choice) and regulations that the federal government is completely immune to. When saving money becomes the primary goal, as is already the case in this boondoggle bill, when "social justice" (as in determining the public's money might be better served spent elsewhere or spent on a more politically expedient demographic) enters into the picture, we have the foundation of making of a charged and chaotic disaster out of a solid health care system in need of simple renovation.
Check out this article by Wesley J. Smith (h/t Pundit and Pundette) regarding the issue. It's a short piece and be sure to check out the comments especially the first one. Here's a sample from the article, but I highly recommend people to read the whole thing.
"The Medicare 'mandatory counseling' controversy in the Obamacare debate laid bare a realistic fear that compensated counseling under Medicare could easily become subtle (or not so subtle) persuasion to refuse treatment–particularly since the primary point of the clause is to cut costs.
"Here is an example of why I believe that the fear is realistic. The Center for Practical Bioethics has published a 'Caring Conversations' workbook, in which intimate issues and details of life, death, and end of life options are raised. Nothing wrong with that, in and of itself, of course. It all depends on how it is done."
The problem with counseling sessions is that they almost always end up being persuasion sessions. For the counseled, it really comes down to being a matter of trust. Does the counseled trust the persuasion to be with their best interests in mind? A person generally trusts their family doctor to be looking out for their best interests , or at least they should, (as in if they don't then they need to find another doctor that they do trust). However, when counselors, trained to be appear trustworthy, armed with cleverly written and persuasive workbooks, enter with the full weight of federal authority behind them... Well, you get the picture, and it's not pretty.
Yes, of course it is true that private insurers are driven to make money. However, they are subject to various market forces (such as consumer choice) and regulations that the federal government is completely immune to. When saving money becomes the primary goal, as is already the case in this boondoggle bill, when "social justice" (as in determining the public's money might be better served spent elsewhere or spent on a more politically expedient demographic) enters into the picture, we have the foundation of making of a charged and chaotic disaster out of a solid health care system in need of simple renovation.
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