Healthcare

[linemanpaul]

Way to important not to have a thread of it's own. Please post anything about the debate going on today. And away we go!!!

DEADLY DOCTORS
O ADVISERS WANT TO RATION CARE

By BETSY MCCAUGHEY
Emanuel: Believes in withholding care from elderly for greater good.

TODAY'S HOT TOPICS


THE health bills coming out of Congress would put the decisions about your care in the hands of presidential appointees. They'd decide what plans cover, how much leeway your doctor will have and what seniors get under Medicare.

Yet at least two of President Obama's top health advisers should never be trusted with that power.

Start with Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel. He has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research.

Emanuel bluntly admits that the cuts will not be pain-free. "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely 'lipstick' cost control, more for show and public relations than for true change," he wrote last year (Health Affairs Feb. 27, 2008).

Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, "as an imperative to do everything for the patient regardless of the cost or effects on others" (Journal of the American Medical Association, June 18, 2008).

Yes, that's what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.

Many doctors are horrified by this notion; they'll tell you that a doctor's job is to achieve social justice one patient at a time.

Emanuel, however, believes that "communitarianism" should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those "who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia" (Hastings Center Report, Nov.-Dec. '96).

Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy.

He explicitly defends discrimination against older patients: "Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years" (Lancet, Jan. 31).

The bills being rushed through Congress will be paid for largely by a $500 billion-plus cut in Medicare over 10 years. Knowing how unpopular the cuts will be, the president's budget director, Peter Orszag, urged Congress this week to delegate its own authority over Medicare to a new, presidentially-appointed bureaucracy that wouldn't be accountable to the public.

Since Medicare was founded in 1965, seniors' lives have been transformed by new medical treatments such as angioplasty, bypass surgery and hip and knee replacements. These innovations allow the elderly to lead active lives. But Emanuel criticizes Americans for being too "enamored with technology" and is determined to reduce access to it.

Dr. David Blumenthal, another key Obama adviser, agrees. He recommends slowing medical innovation to control health spending.

Blumenthal has long advocated government health-spending controls, though he concedes they're "associated with longer waits" and "reduced availability of new and expensive treatments and devices" (New England Journal of Medicine, March 8, 2001). But he calls it "debatable" whether the timely care Americans get is worth the cost. (Ask a cancer patient, and you'll get a different answer. Delay lowers your chances of survival.)

Obama appointed Blumenthal as national coordinator of health-information technology, a job that involves making sure doctors obey electronically deivered guidelines about what care the government deems appropriate and cost effective.

In the April 9 New England Journal of Medicine, Blumenthal predicted that many doctors would resist "embedded clinical decision support" -- a euphemism for computers telling doctors what to do.

Americans need to know what the president's health advisers have in mind for them. Emanuel sees even basic amenities as luxuries and says Americans expect too much: "Hospital rooms in the United States offer more privacy . . . physicians' offices are typically more conveniently located and have parking nearby and more attractive waiting rooms" (JAMA, June 18, 2008).

No one has leveled with the public about these dangerous views. Nor have most people heard about the arm-twisting, Chicago-style tactics being used to force support. In a Nov. 16, 2008, Health Care Watch column, Emanuel explained how business should be done: "Every favor to a constituency should be linked to support for the health-care reform agenda. If the automakers want a bailout, then they and their suppliers have to agree to support and lobby for the administration's health-reform effort."

Do we want a "reform" that empowers people like this to decide for us?

Betsy McCaughey is founder of the Committee to Reduce Infec tion Deaths and a former New York lieutenant governor.

DEADLY DOCTORS - New York Post

[SAINT_X]

Do you know how much big pharma spends on advertising...JUST ADVERTISING...in a year?

http://www.fiercepharma.com/special-...tising-budgets



If this isn't out of control I don't know what is. Can you imagine how much of this cost is passed on to you? Something HAS to be done.


Who is going to do something about this if not our Govt...? ( of, by, and for the people, in case ya'll forgot )

[Chopper_Dave]

The Aspirin Tax

I JUST HEARD THAT OBAMA IS GOING TO IMPOSE A 40% TAX ON ASPIRIN BECAUSE IT'S WHITE AND IT WORKS.

[SAINT_X]

Originally Posted by Chopper_Dave

The Aspirin Tax

I JUST HEARD THAT OBAMA IS GOING TO IMPOSE A 40% TAX ON ASPIRIN BECAUSE IT'S WHITE AND IT WORKS.

OK...granted, that's horrible...blabbedly blabbedy blabb...I admonish you....etc...

...but danged if I didn't bust out laughing when I read that...

[A1food4U]

Originally Posted by SAINT_X

Do you know how much big pharma spends on advertising...JUST ADVERTISING...in a year?

http://www.fiercepharma.com/special-...tising-budgets



If this isn't out of control I don't know what is. Can you imagine how much of this cost is passed on to you? Something HAS to be done.


Who is going to do something about this if not our Govt...? ( of, by, and for the people, in case ya'll forgot )

I have to agree with you on this snippet of the arguments. My daughter's are sports fans and we regularly sit down to watch a ball game or hockey. But I'm really getting tired of having to sit next to them feeling uncomfortable because all the cialis and viagra not to mention the extenze commercials are allowed to be aired in prime time slots these days !!!

[tooncesthecat]

Name one thing the government has done on budget and without red tape. Don't mess with our healthcare. I agree something must be done but the government dictating healthcare is so scary that I shutter to think about it.

[linemanpaul]

FUCK N A , now this should be a GREAT FORUM, lets keep it up. I want to see all sides of the "Healthcare" argument. We`have a fantastic assortment of views and opinions about this issue. KEEP IT CIVIL, NO PERSONAL ATTACKS, DEBATE THE ISSUE THAT WILL EFFECT EVERYONE, AND AT THE END OF THE DAY HOLD NO GRUDGE!!!

[linemanpaul]

Shit on two legs like the very leeeeeeeeeeeft leaning Jack Cafferty help to distort the issue

A

re health care protests legit or orchestrated?
Posted: 04:00 PM ET


FROM CNN’s Jack Cafferty:

Depending on who you ask — the protests against health care reform may or may not be the real thing.

Democrats and the White House claim these sometimes rowdy protests that have disrupted meetings and health care events around the country are mostly orchestrated by insurers, lobbyists and Republican activists. They’re accusing the GOP of organizing “angry mobs” and trying to destroy President Obama.

Nancy Pelosi even claims protesters are “carrying swastikas and symbols like that” to these meetings.

But Republicans insists these protests are just a sign of real opposition and frustration about the president’s health care plan… they say the protests are part of a ground-level movement.

Republican Party Chairman Michael Steele says “We’re not inciting anyone to go out and disrupt anything.” Steele calls the Democrats’ claims “a bunch of baloney” and says there’s no upside for the Republican Party in the protests.

Meanwhile — a new CNN/Opinion Research Corporation poll shows the nation is pretty evenly divided over the president’s health care plan — with 50-percent supporting it and 45-percent opposed.

The poll also shows that more than half of Americans have strong feelings about this debate… with one-third saying they strongly oppose Mr. Obama’s plans and 23-percent saying they strongly favor them. The poll also suggests that those against the president’s plan may be more motivated to attend town hall meetings than those who support it.

Cafferty File: Tell Jack how you really feel Blog Archive - Are health care protests legit or orchestrated? - Blogs from CNN.com

[SAINT_X]

OK...

Just one of the top 20 big pharmas has an advertising budget of nearly 3 billion dollars. That is just completely insane...how can they justify that? And for what? So they can further offend us by running viagra ads where our children can see it in primetime? That is wrong on multiple levels...very wrong. I shudder to consider what sort of evil is at the heart of this...

And that is just big pharma. And I will barely even address how they have bought influence that allows them access to govt policies that pave the way for them to take advantage of taxpayer funded research only to sneak in at the end for lucrative patent rights.

It cannot be easy to defend a system that leaves nearly 50 million of it's citizens un-insured, but I guess it's easier to get people on your side when you have the kind of billions our healthcare system steals from us in order to buy the best and the brightest of modern manipulators and corporate media...heck...I'm sure some of them you don't have to buy, they already have you in their portfolio...

How many people have to lose their homes to catastrophic illness before it becomes unthinkable for any person to say our system is fine? And in these uncertain times how many people have to lose their jobs - and insurance - only to find upon re-employment, if they are lucky, that they will not be able to be insured again for a prexisting condition? I don't know about ya'll, but I know people who this stuff has happened to.

Bush liked to talk about evil alot, but he never applied it to his buddies in the healthcare industry - they paid him too much. But If the abovementioned ( and this is just scrtaching the surface ) practices are not evil, I do not know what is. And if our Govt was formed for anything, it was to stand up for the little guy in the face of exactly this kind of oppressive and entrenched monolithic power.



What does govt do right?

1. The FAA. Crashes are a rarity here, thanks to equipment safety tests and massively successful air flight controlling.

2. Medicaid: private sector insurance companies make money by ditching their customers when they get very sick. Medicaid picks up the castoffs.

3. Social Security: What if Mr. Bush had succeeded in privatizing SS before the markets crashed? Can you imagine how many old people would be working at WalMart, since their SS would have been cut in half? And did you know that before SS, thousands of older Americans simply starved to death?

4. SCHIP: Healthcare insurance for children who would not otherwise have it – enormously preventive of school absence, long-term illness, loss of physical and mental development.

5. The CDC: How do we know that the virulence of H1N1 is less than expected? Who is telling the world that US pork is safe to eat? How do we know whether an illness is H1N1 or not? It’s all the CDC.

6. School hot lunch programs: For many children, their only serious nutrition all day every day. What industry would do it?

7. The Soil Conservation Service: though bureaucratic, there is no private industry comparable. How vastly different would America be without the wetlands your dad and a thousand like him have created.

8. Head Start: kids from homes that have seriously dysfunctional emotional and learning environments have benefited enormously.

9. The Department of Motor Vehicles: how many mistakes have you had on your car registrations or titles?

10. E911 commissions: how long does it take an ambulance or fire truck to reach you if a child who can call 911 can’t tell the operator an address? When I first came to Washington, there was simply no way to know. People died.

11. University of Iowa Hospitals and Clinics – known around the world for ground-breaking medical research.

12. Open meetings laws for city, county, and state government office – nothing like it at all in the private sector. But if public officials make decisions without notifying us, they can get in big trouble.

13. Free public libraries – which most nations simply don’t have.

etc... etc...

[tooncesthecat]

Excellent points Saint. However, I still don't like the idea of government running healthcare. They underestimate the costs. There are people smarter than me with ideas such as co-ops which should be given consideration. I don't like the way Obama is rushing this legislation through. Hell, he gave more time to looking for his dog than to considering the options for healthcare

[linemanpaul]

Come on X, explain how these made up programs are my responsibility, they would be #3,4,6,8. Someone needs to explain to Congress point #12, but I digress

[wil]

The stuff that annoys me about this...

From articles I have read (and not all from those kooky right wing rags... here is one from the Wash Post... washingtonpost.com ) most (80% or so) people are satisfied with their current health coverage. So why does the whole system need an overhaul?

People throw out that 45-50 million people do not have health insurance. Again, this next part has come from different sources I have read or heard... of those there are only 10-12 million people who are legal U.S. citizens with income below 300% of poverty not on or eligible for a taxpayer-subsidized health insurance program (Medicare, Medicaid, S-CHIP) and not a childless adult between age 18 and 34 (those figures came from here: How many uninsured people need additional help from taxpayers?|KeithHennessey.com ). So again I ask why does the system need an overhaul?

Obama et al say this will increase competition. That is total bullcrap and anyone with a drop of economic knowledge should understand why. The gov't will have the advantage of setting the rules. They don't have to concern themselves with being profitable or at worst breaking even, so they can basically undercut everyone in the private sector without any repurcussions. If they lose money (which the gov't has a fantastic track-record of doing) they just TAKE more money from taxpayers. And eventually the private insurance companies will go out of business. Obama has said that he wants to do that... Breitbart.tv Obama in ‘03 (Uncut): I’d Like to See a ‘Single Payer Health Care Plan’



And now to my biggest problem of all...

As usual in Washington DC, the congressmen and women and the president pushing for this WILL BE EXEMPT FROM THE LAW THE WILL FORCE UPON US. Could someone who supports this plan explain that one to me?


I may never be affected by it... the gov't could take over and my health care could not even change one bit... I realize that. But I also realize that politicians want POWER over the people.

And in Obama we have a president who has stated that he wants to "fundamentally transform the United States of America" ...

YouTube - Obama: We are 5 days from FUNDAMENTALly...

From what I have seen in 7 months, I don't think I like his idea of what the "Transformed America" will look like.

[A1food4U]

Originally Posted by tooncesthecat

Hell, he gave more time to looking for his dog than to considering the options for healthcare

Yes but he has to live with that dog himself, and that is a very important point!!!!

As long as the federal employees, senators, representatives and executive branch are given free health care of the best quality for no out of pocket expense, we will see NO significant and realistic change in our system that doesn't include mind numbing B.S.. The system will remain broken as long as it is largely a class system with our OWN GOV'T BEING THE UPPER CLASS. BUT if you make them go through the same B.S. we all have to I bet you'd see effective change really quickly!!!!

""As usual in Washington DC, the congressmen and women and the president pushing for this WILL BE EXEMPT FROM THE LAW THE WILL FORCE UPON US. Could someone who supports this plan explain that one to me? ""
Abso-F'in- lutely my point Wil

[linemanpaul]

Coming from a non right wing source, Iam shocked

Obamacare's Fatal Flaw
By Ramesh Ponnuru Monday, Aug. 17, 2009

There are two basic points about health-care reform that President Obama wants to convey. The first is that, as he put it in an ABC special in June, "the status quo is untenable." Our health-care system is rife with "skewed incentives." It gives us "a whole bunch of care" that "may not be making us healthier." It generates too many specialists and not enough primary-care physicians. It is "bankrupting families," "bankrupting businesses" and "bankrupting our government at the state and federal level. So we know things are going to have to change."

Obama's second major point is that--to quote from the same broadcast--"if you are happy with your plan and you are happy with your doctor, then we don't want you to have to change ... So what we're saying is, If you are happy with your plan and your doctor, you stick with it."

So the system is an unsustainable disaster, but you can keep your piece of it if you want. And the Democrats wonder why selling health-care reform to the public has been so hard?

Again and again, their effort has brought us into a land of paradoxes. Public skepticism is warranted when the President promises to cut costs while simultaneously providing coverage to nearly 50 million uninsured people. It is even more warranted when his congressional allies seek to raise taxes to pay for all the new spending that this cost-cutting entails. We aren't talking about short-term spending either; this isn't a trillion-dollar investment in a new system that will ultimately save money. The Congressional Budget Office says the leading health-care-reform proposals will increase health-care spending and make the budget harder to balance in the long run. Yet saving money is the President's principal stated rationale for reform.

Health-care reformers send out mixed messages on the uninsured as well. The moral imperative of improving their health care is what drives the passion of most liberal activists for reform. But when you read the liberal policy analysts, it quickly becomes clear that getting young and healthy people to pay more in premiums than they will spend on medical expenses is the point of forcing them to buy insurance. Which is it? In aggregate, are we trying to rescue the uninsured or bilk them? Is reform something we are doing for them or to them?

The reformers' speed belies their words as well. If health-care reform is so critically important, as they keep insisting, why not take the time to get it right? Hard as it is to believe, at one point Obama was urging the House and Senate to pass legislation by three weeks after they began debating it.

One final contradiction may lie beneath all the others. Democrats, particularly those involved in health policy, were scarred by President Clinton's failure to achieve reform in 1994. They are determined to avoid a similar debacle. So on every procedural question, they have done the reverse of what he did.

Everything is different this time--everything, that is, except the plan. The Democrats are seeking mostly the same policies they sought 15 years ago: mandates, regulations on insurance companies, new government-managed markets. The major difference is that this time they also want a "public option," an insurance program open to everyone and run by the government. Obamacare is Clintoncare with a little more liberalism.
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The Democrats have apparently concluded that it was tactical blunders that sank Clinton. It wasn't. It was his plan. Like today's plans, it had too many conflicting goals.

Stanley Greenberg, who was polling for Clinton back then, recently reminded Democrats that the insured public in the early '90s just could not be persuaded that the President was going to cut its costs by expanding coverage for others. No amount of clever strategizing is going to make the sales job easier this time. Instead, the President is in a series of double binds. The more he emphasizes how much has to change, for example, the more people are going to doubt his pledge that they can keep their doctor.

Congress may yet pass the health legislation Obama wants. If it does, that success will reflect the Democrats' numbers in Congress and their determination, not public enthusiasm. This time there is no barrage of Harry and Louise ads to blame. It is health-care reform's own contradictions that are causing it to sink.

Obamacare's Fatal Flaw - TIME

[linemanpaul]

Have not heard any talk about this

[jack9]

Since I am one of those gorillas in the picture, I'll weigh in on this one:

Gov't run health care is not the scary monster it is being painted as. Why is everyone scared of government standards for what procedures get approved, and when, versus insurance company control. Do you know how maddening it is to try and get something approved by a monolithic insurance co. when they say the doc hasn't exhausted all available conservative options and your highly trained surgeon tells you that in his experience you need surgery and quickly, but he can't get the ins. co.'s doctor of osteopath peer reviewer on the phone to approve things?

And I'll add a couple more government successes to Saint's list--a national highway system and NASA. Hell, while we're at it, how 'bout the military. We all wrap ourselves in the flag when talking about the military, how about recognizing it as a success. Sure they have $400 dollar hammers, but the point is, we caught it and fixed it. With insurance companies, we are at their mercy because the free market has not been effective at lowering ins. costs.

Another aspect that hasn't been mentioned is the business cost of the current system. Our multinational businesses can't compete in the world markets because of the high costs of providing health care. Small businesses can't compete against big business so they don't offer health insurance. That cost then gets passed to taxpayers anyways.

Finally, I think you will find the tort lawyers largely ambivalent. The big money tort lawyers are in the mass torts--mesothelioma, tobacco, etc. Mass torts are like class actions, its not the number per person, its the ability to hit one for a home run and then signing up as many as possible with the threat that you'll step up to the plate on every one and swing for the fences. Your bread and butter trial lawyers (such as myself) are afraid of how gov't health care will reduce the cost of health care, and therefore reduce our contingency fees. But most of us are idealists and I'll still make money with my bar card even if I have to give up a little for a better country.

[jack9]

Oh, and if anyone thinks trial lawyers contribute to the high costs of health care, they are extremely uninformed. Most states have what are called subrogation laws and most insurance plans have subrogation clauses. When I recover money for my clients, I have to reimburse the health insurance carrier for the expense they paid on the claim. If I don't, they can come after me personally. Trial lawyers have nothing to do with the high costs of health insurance. And if your argument is that we contribute to the high costs of pharmaceuticals, think again. Thanks to the trial lawyers, would you want to trust your stiff joints to Merck's Vioxx?

[wil]

Originally Posted by jack9

Oh, and if anyone thinks trial lawyers contribute to the high costs of health care, they are extremely uninformed. Most states have what are called subrogation laws and most insurance plans have subrogation clauses. When I recover money for my clients, I have to reimburse the health insurance carrier for the expense they paid on the claim. If I don't, they can come after me personally. Trial lawyers have nothing to do with the high costs of health insurance. And if your argument is that we contribute to the high costs of pharmaceuticals, think again. Thanks to the trial lawyers, would you want to trust your stiff joints to Merck's Vioxx?

One of the big costs is also one of Obama's big talking points... doctors performing test after test after test after test. But don't they (doctors) pretty much have to do that to cover their asses from being sued? And isn't the threat of lawsuits the reason why doctors and hospitals have to shell out so much for insurance? I'm not an expert in the medical field but it's usually basic economics that the costs incurred by a producer (doc/hospitals) are passed on to the consumer (patients).

Or is that another case of those greedy docs just ordering gobs of unnecessary tests and procedures to line their pockets? I would be interested in hearing a doctor's opinion on that.

[linemanpaul]

So tort reform does not need to be addressed in any part of "Healthcare Reform"?, I am sure John Edwards would agree.

[jack9]

I think the "test after test after test" talking point is pure trash. Doctors have a standard of care. That standard comes from a way of practicing medicine based upon a differential diagnosis. What that means is that doctors must rule out other, more probable diagnoses before settling on the final diagnosis. I will admit that there is some CYA going on by doctors ordering unnecessary tests to make sure they don't get sued, but I think there is a lot of unnecessary testing done so that the doc can make a little more money as well. Keep in mind that medical malpractice is the most unsuccessful type of litigation there is--plaintiffs lose far more than the doctors. What makes it lucrative for we trial lawyers is that when you win, you win big.

As for tort reform being a part of healthcare reform, as far as I can see, tort reform has been a separate issue from healthcare reform for some time now. Karl Rove made it an issue when he saw how many tort lawyers were donating to Democrats. Medical malpractice reform may need to be a part of healthcare reform, but that is only one small subset of tort reform. If big business gets its way with tort reform, only big business will be able to bring lawsuits. As for medical malpractice reform, again, as it relates to the national debate about health care, I think you will find alot of us trial lawyers ambivalent. Bad doctors are still going to be bad doctors. Those of us who are good trial lawyers are still going to get hired and still going to make money as long as there are doctors with drug and alcohol problems, god complexes, etc.