Headlines 8/31/09

=Bill would give president emergency control of Internet
This make anybody else uneasy?

=Feds to use kids in census
This make anybody else uneasy?

=ABC, NBC Won't Air Ad Critical of Obama's Health Care Plan
They're barely even pretending to be objective anymore; maybe it's for the best.

=Secret process sends stimulus funds to pet projects
Post-partisanship at its finest.

=Car dealers may or may not get the "clunker" money
The feds can't even give away money right.

Headlines 8/27/09

Sorry for the silence; work has just been nuts.

Whatever Happened to the Work Ethic?
He thinks liberals and capitalists killed it. Long but well worth the read.

Bed shortage forces 4,000 UK mothers to give birth in elevators, corridors
But at least it was free.

'Win One for Teddy,' Say Dems Pushing for Health Reform
say, "Let's pin it on the dead guy."

CIA Interrogation Program Was Effective and Circumscribed
You've heard the liberal media's party line; here's the conservative one.

Democrat attacks Democratic Party HQ (video)
Another attempt at setting up conservatives?

Headlines 8/24/09

Health Insurers Fear Probe Is Reprisal
House Energy and Commerce Committee is "examining executive compensation and other business practices of the health industry."

As vets await checks, VA workers get $24M bonuses
I guess compensation and business practices are not a concern here.

Competition lacking among private health insurers
...so let's create a federal monopoly.

Just how stupid do they think we are?
A question we probably don't want answered...

Government Healthcare: Viagra for Pedophiles!
If ever there was a headline that provided it's own commentary...

Change

This was too good not to share:



(source: Comics Continuum)

Goverment Health Care: A Metaphor

A columnist for The Independent, in sharing the trials he has undergone trying to get health care for his disabled daughter in Great Britain, admitted that his experience wasn't the only version you'll hear even as it isn't unique.

"...[F]riends who have suffered heart problems, cycling accidents or had very premature babies will testify to flawless treatment. But then I know of other friends with equally terrible experiences of arrogant doctors, disinterested nurses, lost files and suchlike."

This reminds me of what I think is one of the best pictures of how a government-run health care system would work: the public school system.

Some public schools are great. Some are a train wreck. It varies widely depending on where you live, and you get what you get unless you've got the money to spring for private care school.

Single-Payer is Great

I've worked with a number of people who lived and/or worked in the Canadian or British health care systems. Adding their stories to my up close view of Medicare, I think I can sum up their experience of living with these systems:

"It's great as long as you're basically healthy."

If you get pregnant, break an arm, or need some medicine, you're taken care of. You have nothing to worry about, and that, I think, is the origin of statments like "you don't have to worry about being ruined when you get sick."

But when you get real sick you have no idea what's going to happen.

But isn't that the case here? No. Here it's the case with some people. There it's the case with everyone.

Health Care Headlines 8/19/09

4We Don't Spend Enough on Health Care
"Japan spends 8% of its GDP on health care—the same as Zimbabwe."

Um, perhaps we need a different measure.

4Whose Medical Decisions?

"There are more Magnetic Resonance Imaging (MRI) devices per capita in the United States, more coronary bypass operations and Americans use more new pharmaceutical drugs created within the past 5 years."

In other words, we get what we pay for.

4Medicare For All Isn't The Answer

"...[H]ospitals received only 94.1 cents for every dollar they spent treating Medicare patients in 2007. MedPAC projects that number to decline to 93.1 cents per dollar spent in 2009, for an operating shortfall of 7%. Medicare works because hospitals subsidize the care they provide with revenue received from patients who have commercial insurance. Without that revenue, hospitals could not afford to care for those covered by Medicare. In effect, everyone with insurance is subsidizing the Medicare shortfall..."

And if we all go into Medicare (or something similar), our healthcare system will go broke.

4A Trojan Horse Rises (video)

Headlines 8/18/08

=Man carrying assault weapon attends Obama protest
He's defending his right to bear arms ... and creating sympathy for the other side.

=Speaking of which...
Black Man Pleads Guilty to Posing as Obama-Hating White Supremacist on Facebook
If there is an assasination attempt on Pres. Obama, I'm going to be looking for a setup.

=Obama Administration Says DOMA Unfair
They're simultaneously attacking and defending DOMA in court.

=Endangered Species Act Causes Drought
Sometimes the Feds have weird priorities. You can relate this to health care if you want.

Co-op Sucker Punch?

By now you've probably seen the news: White House appears ready to drop 'public option.' This is great news, right?

But if the "public option" is being replaced by "co-ops," we need to ask if they're really different or if this is just "rebranding."

So far the prescription is $3-4 billion "seed money," which, ala Fannie Mae, would

"provide a lower cost of capital than private firms and an implicit claim on any other money the co-ops need. The feds may also exempt co-ops from the taxes that private insurers pay, which average about 1.2% of premiums. This would let co-ops offer lower prices and poach customers with government-subsidized premiums."

So, the government can still use regulation to undercut private insurance and push people into the co-ops. Depending on how much government control the co-ops have, this could quickly turn into the public option, and we're really back to square one.

Remember that many Democratic officials have already said publicly that the "public option" was simply a road to a single payer system. As one commentator put it, "[the public option] was never more than a means to an end. If this means isn’t working, they’ll find one that will."

Does that mean that co-ops are irredeemable? I don't think so. What we need is to keep government money and control to a minimum.

1) They should simply specify the policy they want and let the market produce it. No regulations, just say, "This is what we'll buy."

2) No artificially low premiums. That's not to say we can't give need-based assistance on premiums, but a person's unsubsidized premium should be based on the market, not on government price controls.

3) No price fixing. Let these co-ops negotiate their prices just like any other insurance company. If prices get too high, then the feds have to find a cheaper insurer.

4) People who buy into the co-op should get to use pre-tax dollars or get a tax-credit for it.

If the co-ops are constructed properly, they would be what many conservatives have wanted for years -- allowing people to form groups to buy health insurance as a collective across state lines to get the best prices. The only thing that's stood in their way for years has been federal law. Maybe now we can try some real conservative solutions to our government-created health care mess.

But is that what we have here? I doubt it. So, as others have pointed out, this is not the time to rest on our laurels. Keep the pressure on. Let Congress know that a "co-op" that is nothing more than a public option is not acceptable.

Headlines 8/14/09

=Senators exclude end-of-life provision from bill
Yeah, but watch out for the conference report.

=The ‘Preventive Care’ Myth
Turns out prevention doesn't necessarily save much money. Darn. I was actually with the Prez on this one.

=What to Do with the Uninsured
A novel approach to making the voluntarily uninsured responsible for their own care.

=Liberals Boycott Whole Foods
When conservatives do it, they get ridiculed, but Mackey should have expected this.

Headlines 8/13/09

=Reading a Bill 101

=Healthy examples: Plenty of countries get healthcare right.
Of course, our pols are on record saying the "public option" should evolve into single-payer.

Still, this is worth talking about. Not every country's health care system is the train wreck that Canada's is. What can we borrow from them?

=The Truth About Health Insurance

"If you develop an expensive condition such as cancer or heart disease, and then get fired or divorced or your employer goes out of business—then individual insurance is going to be very expensive if it's available. But what the President and Democrats won't tell you is that these problems are the result mainly of government intervention."

(...as with so many things.)

=The Whole Foods Alternative to ObamaCare: Eight things we can do to improve health care without adding to the deficit.

So much good stuff here, but I want to highlight this:

"Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor's Business Daily. In England, the waiting list is 1.8 million.

"At Whole Foods we allow our team members to vote on what benefits they most want the company to fund. Our Canadian and British employees express their benefit preferences very clearly—they want supplemental health-care dollars that they can control and spend themselves without permission from their governments."

Apparently they don't think the government is the best source for their health care.

Mess Makers

I've already briefly commented on the President's statement that those who created our health care mess shouldn't do a lot of talking, but it still sticks in my craw, so I'd like to elaborate a bit.

4Our employer-based health insurance system arose because of wage controls created by Congress.

4It was further strengthened when Congress made employer contributions to health insurance tax free.

4Congress made it illegal for most people to buy health insurance across state lines, keeping people from finding the cheapest coverage.

4Congress created Medicare and Medicaid which mimicked the employer system in hiding medical costs from the patient.

4When the system they created got out of control, Congress created the HMO.

Given the raging success they've had in the past, why would we want them to create another health care system?

Checking the Fact Checkers

I'm glad there are professional "fact checkers" in the media, even if I don't always believe they're as non-partisan as they claim. But sometimes the fact checking is, whether intentionally or not, excessively literal. 

For instance, one piece run on Yahoo!: 

Phrases like "euthanasia," "socialized health care" and "rationing" are still being bandied about. (None of which are in the health-care bill, by the way.)

It's true that those terms don't appear in the bills in question. Opponents of those bills don't claim that they're in there. They claim they're the natural result of what's in there.

For example, the current bills tend to call for insurance "exchanges" for people without employer-based health insurance. Those employers who don't provide such insurance would have to be a fee for their employees who are in the system, but those who have insurance can continue to offer their current program.

But if the government raises the requirements for private insurance, raising the cost of providing it, and lowers the fee to put your employees in the exchange, more companies will find it more cost effective to drop their insurance. As this continues, insurance companies will go out of business, further raising prices, putting more and more people into the exchanges. End result? A single-payer health care system (commonly referred to as "socialized medicine").

And though the president claims this is not the result he wants, in the past he explicitly said the opposite, and so have many other Democratic lawmakers.

Rationing and euthanasia are the same -- likely results of the current legislation rather actual line items.

So when you read "fact check" pieces, read them with a certain grain of salt.

And if you oppose the steady march to single-payer health care, be sure to let your Congressmen, both Democrat and Republican, know.

Health Insurance: Perspective

Part of the reason health insurance is so expensive is what we expect it to do.

If car insurance worked like health insurance, it would pay for your oil changes or at least fix a transmission.

If homeowners insurance worked like health insurance, it would paint your house.

It might sound good, but how much would that cost? These things cover catastrophic, or at least major, losses -- theft of a car or death in an accident, houses that burn down or lose a roof.

If health insurance didn't have to cover fertility treatments, acne medication, and viagra, it would be much more affordable. If we pay for our own minor illnesses (e.g., pink eye, ingrown toenails), it can be cheaper still.

Make it pay for everything for everybody, and even government won't be able to afford it.

Headlines 8/10/09

=Obama's Mexico Mission: Keep Guns in El Norte
...which could never be accomplished by controlling our border.

=Fact Check: Obama Consistent in His Position on Single Payer Health Care
From Senator Obama's campaign website:

"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."

Emphases added to point out what Mr. Obama used to say as opposed to what he says he said. (HT: Verum Serum)

=Psychological barriers hobble climate action
...like a lack of trust of politicians, environmentalists, or scientists who make their living preaching global warming.

Headlines 8/7/09

4By now I'm sure you've heard the White House wants us to report emails and such that are "misleading" regarding health care insurance reform. Many have been forwarding Democratic emails and websites, but Mark Steyn had the amusing notion of forwarding them all the viagra and Nigerian widow emails you get. We might as well have fun with this until Big Brother comes and gets us all.

4"I Don’t Want the Folks Who Created the Mess to Do a Lot of Talking" (video)
Um, Mr. President, that would be Congress.

4Health Reform and the Polls

"74% of voters rate the quality of care they now receive as good or excellent. And 50% fear that if Congress passes health-care reform, it will lead to a decline in the quality of that care."

AstroTurfing. Riiiight.

4Care Versus Control
"Thirty-thousand Canadians are passing up free medical care at home to go to some other country where they have to pay for it. People don’t do that without a reason."

Headlines 8/6/09

=Hispanic senator warns Republicans on Sotomayor vote
...Dems to turn vote on principle into vote on race.

=Republican Opposition to Sotomayor Widens Court Gulf
...which is the natural result of judicial activism.

=Murdoch vows to charge for all online content
Yeah, this was bound to happen sooner or later.

=Coffee Shops Pull the Plug on Laptop Users
So was this.

=Reagan on Socialized Medicine



It's long but worth it, especially the ending.

"The Last Six Months"

Lately I keep seeing one idea repeated in regard to Medicare costs:

The Medicare system spends about 80 percent of its funds during a patient’s last six months of life.

This is brought up to say that we need to reconsider how much we're spending on end of life care.

The problem is, we don't know when someone's at the end of life. A 65-year-old man having a heart attack may only live three months even with the best of care, or he may have ten more years in him. Who's going to decide which way we should bet?

If we're not careful, government guidelines.

Medicare: Shades of Things to Come?

On my recent post Is Health Care a Right?, Vinny commented,

Do you realize that the United States already has nationalized health care for the elderly? We have had it for forty years. It's called Medicare.

I thought that was important enough to warrant a separate post.

Medicare is indeed a type of socialized medicine, and as such we should consider how well it has worked in discussing nationalized health insurance. Here are some important facts to consider.

1) To save money, the government periodically cuts Medicare payments by fiat. A procedure Medicare paid a few thousand for in the 80s may only get a few hundred today. Sometimes this is due to to changes in technology, but sometimes it's just a cut.

2) When Medicare payments are cut, other patients feel the squeeze. It takes a certain amount of money to run a medical practice or a hospital. If Medicare patients (who make up a large percentage of patients in many specialities) pay less, other patients may have to pay more to make up the difference. If that sounds unfair, remember ...

3) When Medicare payments are cut, doctors and hospitals feel the squeeze. Many will stop accepting new and even current Medicare patients. In the latest round of Medicare cuts, it appears radiation oncology (my field) is going to take a particular hit with some practices seeing 30% cuts.

At this point, we're not talking about a doctor not being able to pay for his new boat. We're talking about not being able to pay the light bill. A survey (pdf) of members of the American Society of Radiation Oncology (ASTRO) suggests that up to 40% of practices may have to close down, and more will "consolidate" offices -- meaning they'll close locations.

All of this means ...

4) When Medicare payments are cut, Medicare patients feel the squeeze (pdf). "Managing" medical costs by simply cutting reimbursement means that Medicare patients have a harder time finding a doctor and may have to travel farther to get the treatment they need.

In radiation oncology, where patients are often treated Monday-Friday for six or seven weeks, increasing travel can cause a great hardship, especially when you consider that Medicare patients are already living on a rather limited income.

And after all of that ...

5) Medicare will be broke in about 10 years. If Medicare is the model for how the government will provide health care to everyone at an affordable price, it has failed. The only reason it has survived as long as it has is because it exists along side a robust free-market system.

So what about Medicaid? It's worse. It pays less than Medicare, so their patients have a harder time finding doctors. The VA? Don't get me started.

So what will happen when everyone is in a system like Medicare? Look at Great Britain and Canada, and see the lottery to get a family doctor, the do-it-yourself dentistry, the lack of ICU beds, and the wait to get a heart bypass, and ask if "free" health care is worth the cost.

Some Healthcare Reform Links

A Long, Long Post About My Reasons For Opposing National Health Care
Megan McArdle; the money quote: "The one industry where the government is the sole buyer, defense, does not have an encouraging record of cost-effective, innovative procurement."

Health Care
A simply named but long, thorough, and thoughtful piece by a doctor.

Utopia Versus Freedom
Thomas Sowell says we're never going to reach Utopia, so let's be more realistic about this problem.

How to Fix the Health-Care ‘Wedge’
Art Laffer on the problem with ObamaCare. The money quote: "Implementing Mr. Obama’s reforms would literally be worse than doing nothing."

He also talks about what shape a real solution would need to take.

Do You Have a Dem in Congress?

My senators and representative are all Republicans. If you have a Democrat or three, you have opportunities I don't to influence the shape of the health care reform debate.

=If you are opposed to government control of a massive slice of our economy, a "public option," or even simply some provision in the Waxman bill, you need to let your members of Congress know.

=You can write (paper is better than email), call, or best of all, go see them during their break.

=If you go to a townhall meeting, some good questions to ask are:

4Have you read the entire bill? (If not, do you intend to?)
4Would you put members of Congress and their staff under this program? (Why not?)
4Given that Medicare, Medicaid, and Social Security are all but broke, what makes you think government should run the health care system?
4Since Canada sends the patients it can't handle here, why should we emulate their health care system?
4What government agency can you point to as so efficient and cost-effective that it would be a model for our health care system?

=Be agressive, but be polite.

(Be sure to forward this to your blue state friends.)

Headlines 8/3/09

=2 Obama officials: No guarantee taxes won't go up
We're about to get the bill for the "stimulus" we didn't want. Since most of it hasn't been spent yet, can we call it off?

=Caught in a Lie: Obama Explains How Health Care Plan Will ‘Eliminate’ Private Insurance
I'm sure Bill Clinton is glad his presidency was before YouTube.

=College Grad Can't Find Job, Wants $$$ Back
The entitlement society coming home to roost?

=Patients forced to live in agony after NHS refuses to pay for painkilling injections
A predicted travesty based on a new NHS guideline.