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12 Sep
White House Concedes on Illegal Immigrant Benefit Ban
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Saturday, September 12th, 2009 at 11:01 am | 85 views
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The President was not lying. The President wasn’t speaking of the House plan. The President was talking about the Plan that he was going to sign into law, which was obviously not the House plan.
Rather than saying one good thing about Obama — rather than saying that he’s listening to both the American people and to members of the GOP who have their concerns — as he said in his speech that he was prepared to do — in order to have the final bill be as good as it can be — as evidenced by the fact that he sees the need to ensure that there are good enforcement provisions in the bill — precisely what you guys complained were lacking but which he now recognizes needs to be added — you actually have the audacity to criticize him for doing precisely what you said needed to be done.
Damned if he does. Damned if he doesn’t. Damned by you guys, whatever he does.
Here’s how Thomas Friedman puts it:
http://www.nytimes.com/2009/09/09/opinion/09friedman.html?emc=eta1
- Larry Weisenthal/Huntington Beach, CA
P.S. What I see happening is this: Health Care reform will get signed into law. With the support of the critical number of GOP senators required to overcome the filibuster. But with virtually everyone else in the GOP kicking and screaming against it. And those are the two things that people will remember. Obama getting health care done and the GOP fighting against it, every step of the way. And Americans are going to be happy with what comes out, just as they were happy with Medicare and Prescription Drug benefits and just as every country in the Western world is happy with their own government systems and certainly wouldn’t touch the current outrageously inadequate American system with a ten thousand kilometer pole. And the young voters who supported Obama will stay with him and the Democrats for a generation.
Just to add some fodder to your post, Mr. Mike… the NYTs blog, Prescriptions, ran an article yesterday about how the WH was mulling over ways to deny illegals access to health insurance thru their proposed “exchange” program. This entails legal ways to demand proof of citizenship, which is a legally touchy matter in most avenues.
They are exploring using the SAVE program (Systematic Alien Verification for Entitlements). This, of course, demands that any exchange system, or health plan, is a government program, and not private. This may blow their talking points that the “public option” is administered by private insurance companies, as Medicare C is done. You can’t be a “government entitlement” when it’s private sector provided.
They still run smack dab into the 10th Amendment on portability as well… dictating to states health care coverage they may want to impose as add’l criterial. Do they make the base package to the most stringent criteria as it exists now? And what happens if a state adds more mandated coverage afterwards?
@Mata: What this shows is just how tricky it can be to balance absolutely every competing priority in getting something done. The President is obviously willing to try to satisfy all the reasonable objections in pursuit of a final bill which works the best, for everyone. He’s trying to do what’s within the realm of the possible, to achieve this.
- Larry Weisenthal/Huntington Beach, CA
Larry – Obama saying illegals will not be covered of course is not a lie. He plans on amnesty for ALL illegals. That of course, would make them LEGAL. What is most important, is that your Messiah has plans to deny coverage to people like me (who pays into every system possible so people like him can abuse the system) so he can get illegals to vote for him and his democratic fiends (NOT friends, you will notice there is no R in it). I have had enough of his: transparency, no earmarks, no increase of taxes for anyone making less than $250K, etc. He is a compulsive liar, and I am SOOO glad somebody had the b*lls to call him on it. Too bad you and your kind can’t see the toilet for all the sh*t he’s spewing all around.
My opinion
Madalyn
First, Larry… whatever gets signed into law must originate in the House. That sticky rule about appropriations, guy. And from what I can see, so far that wedding cake/fruit compote cake isn’t even in the oven yet, and is still batter in the bowl.
Obama is in a rock and a hard place, trying to deny aliens living here without a green card benefits. Are you also aware that the “mandate to have insurance” will not apply to those they deny the “public option”? Interesting they will be in a better spot than citizens. We will be forced into some kind of insurance, or be penalized annually. The questionable status alien can opt to get insurance, or not, and not be penalized annually.
Oh yeah… that’s better.
BTW, don’t forget to UNCHECK the “notify me when new comments are added” box below when you add more than one comment to avoid the inbox mail deluge… LOL I have to make a concerted effort at that myself. Just look before you click “send”.
Were that true, it would mean that he has the same “plans” that President George W Bush supported.
LW/HB
The details of competing House and Senate bills get resolved in conference; then they go back to both chambers for final vote. In this case, stronger enforcement provisions could be added during House/Senate conference, with the final bill being sent back to each chamber for a final vote. Even more frequently, objectionable provisions are removed.
It was intellectually dishonest (I won’t call it a lie) to claim that Obama was lying when he said that “illegals” wouldn’t be covered. You can’t claim that the House bill was “his” bill; it wasn’t.
- Larry Weisenthal/Huntington Beach, CA
Obama does not write bills. Obama does not read Bills. Obama knows nothing about health care or anything else; he depends on other people to tell him what to say and what to sign. When he speaks without knowing what he is saying he deserves to be criticized. He is only the President – he is not a king and he is surely not God. America is a nation where we do not put a crown or a halo on a Human Being – and that’s the way we will remain.
@openid.aol.com/runnswim: Poor Larry… He’s stuck to those talking points just like the lies Obama’s been telling on health care. He thinks if he repeats them enough times someone will believe him.
Don’t you get it Larry, Obama can’t point to a plan, or law which DOES NOT EXIST, the suggest that the folks on our side are lying about it.
You think we are just going to take his word for it that the bill will be what he says it must? HA! He’s broken so many of his promises already only a fool would fall for that.
If he really wanted to assure all of us that the promises he has made on health care will be part of a finished bill then why doesn’t he submit language for legislation along those lines and ask Congress to pass it? His party has unstoppable majorities in BOTH houses and this constant excuse making you people do is LAUGHABLE!
If you folks can’t govern according to Obama’s principles with the majorities you have then you have no business remaining in power. Better to turn the job over to the adults!
Mike, If Obama doesn’t get health care passed, then I’ll concede that you were right (#9).
But my personal opinion is that he’s playing you guys like a violin.
- LW/HB
But my personal opinion is that he’s playing you guys like a violin.
But my personal opinion is that he’s playing us all like a violin.
There, Larry…Fixed that for ya.
The fundamental problem that Obama has right now is that he, along with the DNC led congress) has lost credibility on this entire issue. For starters…isn’t this the same president that DID want that earlier version of the bill we’ve been clawing over the past month passed in 2 weeks time before they took a break? That, with GOP members complaining they were completely locked out of the debate and that the various versions of the bills had BIG problems. But, the “debate was over”, and people in opposition were just obstructionist. THEN, when it became obvious that there was enough push back that he wasn’t going to get that bill rammed through congress, the whitehouse, and the president, started issuing not so subtle statements..that the time for debate was over. That the president didn’t not want to hear from the people who “caused the problem in the first place” and that the opposition to the bill,was disingenuous, “myths”, lies, by republicans and organized “mobs”, etc. when even his own CBO office and honest fact checking you care to look at …says the president has not been factually accurate about some of these larger issues (including cost, guarantees about what you can keep, and whether there was specific language in the proposed bills that specifically prohibited the use of Fed money for abortions, or for treating illegals) that the opposition has brought to light. Debate?? What debate. Neither Obama nor the DNC had any interest in debate over this bill. They wanted to ram it through before anyone could actually look at it (sort of like…oh…the “stimulus” bill).
To further complicate, or erode, the presidents credibility on this issue would be the fact that while he’s saying one thing about what his policy is, etc., his own party is out there undermining him at every turn in the media. Obama says…that he’s not seeking to destroy private insurance or to get rid of it, or to push for a single payer, gov run system. And there’s DNC leadership and others…specifically saying the opposite…YES>..they wan’t to take down the private system and this is just a first step to single payer, gov run medicare/aide for everyone. To even further complicate his position on this..Obama himself has earlier been recorded/quoted saying that ultimately that is what HE wants or thinks would be best as well. (although he now denies it as a “myth”….a quick trip to youtube contradicts him using his “own” words.)
Anthony Weiner (NY representative), left Joe Scarb. (MSNBC) speechless when he finally just came out and admitted that that this was in fact their goal….to get rid of private insurance. Joe tried to bring up the point that his own party and the president are telling everyone that this is a myth…and here he is…basically admitting that it’s NOT a myth. Weiner responded appropriately that this is a difference he and others have with the president, but Wenier and his buds are the ones WRITING this bill!! Obama can say whatever he wants.. ….but it’s still gonna be a bill from congress that ends up on his desk with the choice that he can either sign in, or send it back. He cant’ just rewrite it to conform with his views. And given the amount of disarray between his stated (if not changing) position and his own party who controls everything….one has to wonder just how much control Obama and the whitehouse have over this issue. At the very least, I’d say it doesn’t boost my confidence in how much “leadership” is going on when one hand doesn’t know what the other is doing/saying and there is no unity of message even within their own party on such a sweeping issue as restructuring our entire healthcare system in the midst of a financial meltdown and economic crisis.
The “smart-power” white house got their ass handed to them over this issue by stubbornly refusing to listen, and to attempt instead to ram this bill through without debate. They got busted on that then tried to pretend they actually wanted a debate..accusing the “GOP sponsored “mobs” of blocking debate on an issue they didnt’ want to have debate on in the first place! Then they tried to frame any opposition to their bill as mythical, irrational, etc., etc., while behind the scenes they were removing some of the “mythical” language that didn’t exist. Even more than that, having Pelosi and the leadership directly OPPOSE and blockvote down such changes to fix the language to more clearly say (and close any loopholes) what they claim, Obama included, the bill is actually for!! (example: trying several times to put specfic language in all the various versions of this bill to close the loophole that would allow illegals in this country to access the same system)
Without acknowledging that such an unintended loophole “does” exist in the bills various revisions, Obama insists that it’s not true that illegals would have access to the system. That’s what he says. And yet, any attempts to actually introduce specific language in that bill that says that (ie., what Obama claims he wants) have been blocked. The current revisions of the bill do not specifically say that illegals “are” covered….but there is loophole in the wording that could allow it (despite Obama’s insisting that its not what he wants)…that was pointed out and requests were made to close it up. Obama may not intend for the bill to do that…but the nuts in congress DO want it that way, and they were the ones who are writing the bill and opposing efforts from both RNC and moderate democrats to shore up those things so they can get something passed. Obama wants “competition”, and yet when they try to introduce provisions to open up the private insurance industry “nationally” so they can compete in larger pools, (which is what they want to do with their Fed program), they say no. Obama says this is going to be zero net sum….that it’s going to pay for itself. That’s what he wants. There is no one…no one…I know of with any credibility at all on this issue who would say that’s true, or even possible. And yet, Obama continues to say that people who suggest otherwise…are propagating myths.
The only reason these questions have even come to light of day is because of the “oppositions” voices…..who wanted this hashed out, questions answered, to understand things better, to take more time, to be heard, etc. Again, I remind that they tried to have this version of the bill rammed through congress and put on Obama’s desk to sign without “any’ of this debate. Now, Obama seems to be saying…he’ll listen to you, only if you are interested in coming up with ideas on how to implement “his” ideas/goals better. I say that’s not really asking for debate now is it? A debate he never wanted to have in the first place. Damned if you do or don’t? I think not. The white house and DNC leadership stepped in a hornets nest on this one, then tried to ignore the opposition to it and ram it through anyway. That having failed, they then tried to blame the repercussions, anger, etc. of that on others (including their own constituents). They aren’t going to get a bill until they are honest about what they are trying to do, and hashing out a debate on THOSE issues. They (Pelosi and Reid led congress) want a single payer, gov only healthcare (to take health insurance out of private sector). That is their “stated” goal. Obama says, this is NOT what he wants…Biden is less than clear about the point of whether or not the whitehouse is seeking to maintain a public option..or whether they would give that up. In any case, it’s up to HIM to “lead” and get Pelosi Reid on the same page—not blame and chastise the critics and opponents of this bill for pointing those things out.
“The President was talking about the Plan that he was going to sign into law…”
This magical mystical nebulous fabu-bill that jugears the vapid keeps pimping sure does some amazing things, Larry. Where did you get your copy of it, and can you provide us all with a link so we can get copies too?
“But my personal opinion is that he’s playing us all like a violin.”
Patvann- Nero fiddled too, which is what’s really scaring me.
@Patvann: You NAILED IT!
I do agree in part with ole Larry. Obama doesn’t seem to mind at all how angry we get about beiing insulted and called liars, racists, unAmerican and evil. He’s such an asshole that he wants us to be upset.
The problem with Obama’s scheme is that the Independents who voted for him are tending to agree with us so the tactics that Larry is admiring appear to be backfiring.
@Dc said: “Obama seems to be saying…he’ll listen to you, only if you are interested in coming up with ideas on how to implement “his” ideas/goals better.”
You noticed that too hunh?
Even the French media is making fun of him and the Democrats. Le Figaro’s editor could not understand that if 45 million Americans don’t have health insurance, how come only 32 million Americans watched President Obama’s Speech of the Century about Health Care?. You see what Socialism does to you….cannot do the math…
I am responding to Larry.
At the beginning of the health care discussion, Obama articulated two main objectives: (1) to bend the cost curve downward – that is, to reduce the cost of medical services generally and to reduce the rate of cost increases that we have experienced for quite some time, and (2) to make the same quality of medical services available to all Americans regardless of income status. Those are both laudable goals. However, the decision to delegate the entire formulation of the legislation to Nancy Pelosi and company morphed the objectives from what Obama had articulated into a complete government takeover of the healthcare system. (Although I believe that was consistent with Obama’s hidden agenda.) More importantly, both of the original objectives were completely abandoned as Pelosi, with the help of over a thousand lobbyists created a structure of indigestible complexity which delegates rule making authority to at least fifty boards and commissions. These bills are full of references to other sections, cross-references to the tax code, and internal cross-references that are nearly impossible to follow. (I am an attorney with more than forty years of experience reading statutes.)
When scored by the CBO, the legislation will result in at least a trillion dollars in deficits over the next four years and will cover only about a third of the presently uninsured. The legislation expressly discourages innovation in medical technology, and intrudes deeply into the traditional doctor-patient relationship. No longer will your doctor be permitted to try unapproved approaches to treatment even though medical science has proven time and again that people respond differently to the same treatments and that some treatments that are effective in some individuals are ineffective in others.
The legislation is largely patterned after the universal medical care legislation in the states of Massachusetts, Maine and Washington. All three of these programs have failed miserably to achieve the objectives of controlling costs and providing universal care. In fact, all three are responding to impending bankruptcy by reducing coverage, eliminating participants, and rationing treatments. Unlike the Federal government, states do not have the power to print money, and hence they are constrained by budgetary experience.
In my opinion, the costs of medical care are driven by two main engines: (1) the ever increasing sophistication and effectiveness of medical technology. Complex diagnostics, sophisticated pharmaceuticals, elegant surgical techniques, and ongoing medical research all deliver greater curative and treatment success, but they cost money. (2) an increasing population that demands and gets these modern treatments. And there is another element consisting of coverage mandates imposed by both Federal and state governments on insurance policies and government sponsored programs like Medicare and Medicaid. These mandates, the fruit of successful lobbying by providers of quasi-medical devices and procedures run up medical costs in ways that are difficult to track, but are very significant.
Not one of the bills floating around the House or in the Senate address either of these cost factors. Obama pontificates that his plan, whatever it is, will bend the expense curve and will provide savings in medical expenses. However, that rhetoric, however often repeated, can’t possibly do the job, for more people will be receiving more treatments whether one of the pending bills passes or not. There is nothing in the bills that reduces the costs of these treatments except the prospect of denial to people not considered disserving.
Moreover, the plans offer nothing to increase the supply of medical personnel or medical facilities. Hospital construction is hugely expensive due to all sorts of Federal and state mandates that have found their way into the applicable building codes. Medical school remains hugely expensive and there is nothing that facilitates the expansion of existing schools or adds additional schools to the mix or reduces the educational costs. Already we cannot produce an adequate supply of nurses and we import them from India, the Philippines and elsewhere. (Nursing school is also very expensive.) Defensive medicine adds unknown quantities to the mix but tort reform is off limits.
I suspect that some watered down bill will pass Congress and will be signed in a triumphal flourish by Obama. I am doubtful whether his efforts to ram a comprehensive monster down the collective American throat has any chance now that these fundamental defects have been exposed for all to see.
Note the absence of name calling, personal insult or the like.
Obama can only sign the bill congress presents to him. He does not have line item veto. All this talk about “his bill” or the “bill he will sign” is just that… all talk. I am very concerned that he feels he can order congress to do anything or threaten them in any way if they oppose him. He has ordered 16 senators to the WH….evidently the ones who oppose Obamacare. One wonders what he said to them.
@disturber (#17):
The biggest reason all of us have a stake in health care reform is that all of us — you and I and everyone — are a single illness or injury away from personal bankruptcy. I’m a physician and can afford to buy the “best” insurance; yet I can’t find a policy which will assure me that I won’t bankrupt my family, should I get cancer (the most likely form of catastrophic illness). Up until this summer, I was paying more than $22,000 per year for two health insurance policies (Blue Cross and AMA Catastrophic), until the AMA policy put a limit of $15,000 per year on oral prescription drugs. The newest cancer drugs cost between $5,000 and $12,000 PER MONTH. Since the AMA policy wasn’t doing what I needed it for, anymore, I dropped it and am saving about half of my former premiums. But this still leaves me one cancer (or automobile accident or bicycling accident or neurological or organ disease) away from personal bankruptcy. My insurance (for my wife and I) costs nearly $12,000 per year for $8,000 annual deductible. I’m 62 years old, but am perfectly healthy and athletic, as is my wife, who is younger than I:
http://www.ocregister.com/photos/weisenthal-water-laurin-2539328-swim-swimming/pid2539329
Now, if I have to pay nearly $1,000 per month for utterly inadequate insurance, and was paying nearly $2,000 per month for barely adequate insurance, that is no longer available, just imagine buying health insurance for your 85 year old parents. Absent Medicare, we’d all be bankrupt and, absent health care reform, we are all facing bankruptcy. The number one cause of personal bankruptcy in this country are health care expenses in middle class people like most of us, who own their own homes and who have private insurance. This is not the case in France, Germany, Sweden, Norway, Australia, the UK, or Canada (the last two of which have decidedly undesirable systems, which are, however, much beloved by their citizens).
To top it off, one of my kids, recently graduated from college, is an otherwise healthy NCAA Division I championship level varsity athlete with a history of two sports injuries. She applied for private insurance months before her college group insurance ran out and was just last week denied coverage, because of the pre-existing conditions (which have resolved and are unlikely to recur). So now I’ve got a first degree family member who is without insurance coverage. Were there to be an injury or illness tomorrow, we’d be stuck with Medi-Cal (Medicaid), and I’m someone who thinks that health insurance is the number one priority for any person or family and I can afford to help my kid pay for it. We are, right now, appealing and otherwise scrambling to obtain coverage, but, as of now, we are one of the 45,000,000 uninsured.
The Obama administration saw what happened to the Clinton bill and, I think, have played this beautifully. Let’s look at health care reform as a business plan. You need to start out with some form of a draft plan. Then circulate it and let people take pot shots at it. Yes, I agree, the strategy was to ram something through both chambers of congress and sign it into law before before anyone could really figure out what was in the bills. This was a political strategy to get something passed. It failed, and I’m personally glad it failed. I’m glad for the Tea Parties (including yesterday’s) and I’m even glad for the “You lie” (literal) shout out, because all will result in a better final bill (although the loss of end of life counseling is not only regrettable; I’d call it a tragedy — as I explained elsewhere). But, even if the House bill had passed without modification, I would have considered it to be a vast improvement over what we have now.
I should note that even the AMA (in which I am not a member, but which is a traditionally conservative organization) has endorsed Obama’s health care reform effort. This is the organization representing the nation’s doctors, who certainly understand the strengths and deficiencies of the current system and who would certainly not support a “government takeover” of health care or a government intrusion into doctor-patient relationships (see below).
I have big news for you. Blue Cross doesn’t “permit” unapproved treatments. Aetna doesn’t “permit” “unapproved” treatments. United Healthcare doesn’t “permit” unapproved treatments. Nor does Kaiser. Or Humana. Or whomever you care to cite. You know who does “permit” (and pay for) many “unapproved” treatments not “permitted” by the private health insurance carriers? Medicare. I live and breathe in this world, every day. I’ve spent an enormous amount of time writing medical necessity letters, going with patients to Small Claims court (16 separate times, at my own expense and on my own time — won every single case, by the way, counselor), talking to medical reviewers by phone, and talking to medical review panels in person. There is vastly more “rationing” of health care that goes on in the world of private insurance than in Medicare.
Medical review for medical necessity is much more transparent and patient favorable in government-sponsored health care than in privately-sponsored health care. It’s not even close. Private insurance companies can get away with things which would never be permitted in the public sector, where, for example, in Medicare there are 5 levels of review and where patients can call their congressman, many of whom have a medical doctor on their staff to assist constituents with Medicare coverage issues. Medicare has unsurpassed choice in physician and hospitals, the most liberal (in a good way) coverage policies, lowest overall cost (taxes plus insurance premiums plus out of pocket costs), unsurpassed treatment outcomes, the highest level of patient satisfaction, and the lowest personal bankruptcies (see above).
>>The legislation is largely patterned after the universal medical care legislation in the states of Massachusetts, Maine and Washington. All three of these programs have failed miserably to achieve the objectives of controlling costs and providing universal care. In fact, all three are responding to impending bankruptcy by reducing coverage, eliminating participants, and rationing treatments. Unlike the Federal government, states do not have the power to print money, and hence they are constrained by budgetary experience.<<
The best model is the Massachusetts plan.
http://blogs.wsj.com/health/2008/06/03/sign-of-success-for-massachusetts-health-insurance-mandate/
http://www.online-health-insurance.com/articles/health-news-6-9-08.php
It hasn't been a panacea, but it's clearly been an improvement. And it's early on in the process. The biggest problem for all health care systems, including those in Massachusetts, France, and the USA (as currently existing) is runaway cost. Let's go on to address that.
As to number 1, I am in partial agreement. But another important component is the profit margins currently built into the private health care system, with regard to both physicians’ income, overutilization driven by profit-seeking by physicians who make the diagnostic and treatment decisions, and profit margins in the insurance companies.
With regard to the first part of number 2 (increasing demand for the latest and “best”), I again agree. With regard to mandating coverage for new devices and treatments in Medicare, you are arguing against yourself. Here’s what you wrote earlier:
As I wrote above, organized medicine and academic medicine wouldn’t be supporting this legislation, if it really did these things. And private insurance does much more “rationing” of innovative treatments and diagnostics than does Medicare. Yet, despite the fact that Medicare pays for more new and innovative treatment than does privately-funded health care, the total costs of care are lower for Medicare than for privately-funded health care. Medicare controls costs, while providing access to more providers, services, and hospitals, and delivering greater patient satisfaction. What a deal.
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You are complaining that the bill is already more than a thousand pages long. I view it as a first step to a French style system. I think that this is the clear objective. I've explained this elsewhere. No country yet has a good answer to the problem of exploding health care costs, but it's very clear that the first step is to move away from the system we have now toward a French/European/Australian type of system. The current system we have is a catastrophe. Insurance premiums are rising at 30% per year. The only reason Medicare and other public health care plans are so much in the red is that they can't raise taxes as easily as private insurance can raise their premiums. But, in the end, we must pay for health care. Insurance premiums are as great a drain on our economy and prosperity as are taxes (which are comparatively low in the USA, despite all the gnashing of teeth among conservatives).
http://www.forbes.com/global/2006/0522/032a.html
I’ve discussed the first of the above, before. In my med school class at the University of Michigan (1975) we had, I believe, 215-220 graduates (I’ll have to count up the faces on the class photo). Today, there are only 170 students admitted in each class. It’s the same way all over the country. In the late 70s, organized medicine feared a “glut” of physicians and lobbied hard for cut backs. Today, we have an aging population (mea culpa) and a physician shortage. This does need to be addressed (I’d advocate dramatically easing restrictions on immigration of foreign medical graduates), but it’s not at all clear that increasing physicians, under the present system, would do anything other than increase overall costs (see my next post, in which I give an example). It’s going to be difficult to do everything needed in a single, initial bill. We didn’t get into this problem overnight, and we won’t get out of it overnight.
Let’s talk tort reform. I presume that you agree we can’t limit actual damages (costs of medical care, loss of earnings, etc.). This leaves pain and suffering. What’s the lowest cap on pain and suffering which is reasonable? Thirty years ago, California instituted a $250,000 cap (adjusted for inflation, that would be much more today). Texas recently instituted the same $250,000 cap. I’d argue that it would be wrong to go below this. If you have one good kidney and one bad kidney and a surgeon takes out the wrong one and you have to go on hemodialysis, then how much should you be compensated for pain and suffering, beyond merely paying your expenses? I’d probably want (and feel I deserved) 10 million. Anything less than $250,000 would be heartlessly inhuman, in my opinion.
What was the effect of this pioneering tort reform in California? I gave a link for this elsewhere (don’t want to go looking for it now), but there is no evidence at all that this reduced “defensive” medicine, or reduced overall costs. There’s no evidence that this happened in Texas, either. Doctors don’t like to get sued, period. Costs of actual damages are plenty high enough to encourage defensive medicine. Savings on malpractice premiums were not passed along to patients and payers, either in California or Texas.
I agree. And the GOP is doing everything possible to shoot itself in the foot by making it abundantly clear that Obama is passing health care reform despite every weapon the GOP can employ against it. Barry Goldwater opposed Medicare, along with the rest of the GOP. The GOP had some absolutely half-baked, ineffective plan they called “Eldercare.” Today, their only ideas are to allow health insurance to be sold across state lines, Health Savings Accounts, and malpractice reform (been there, done that, in CA and TX without demonstrable benefit). So Obama will get all the credit and the American people will be very happy to see that the number one cause of personal bankruptcy has been rendered a much less threatening problem.
Duly noted, and much appreciated. It’s a pleasure discussing these issues with you.
- Larry Weisenthal/Huntington Beach, CA
Answered # 16 at 6 AM Pacific/9 AM Eastern. Went to spam.
- LW/HB
Let me give you just one of 1,000 examples of why health care will never conform to the rules of market economics, anymore than national defense or police protection would ever conform. And why you could build 1,000 more medical schools, to increase the supply of doctors (and ostensibly create more “competition”), and health care costs would only go up, and not down.
Prostate cancer 101:
Prostate cancer is extremely prevalent among older men. If we live long enough, almost all of us (men) will have it, but, fortunately, few of us will die from it. Today, there is a true epidemic of prostate cancer over-treatment, related to the PSA test, being enthusiastically pushed on all men over 50, with a current movement to push this on all men over the age of 40. I’m a medical oncologist (age 62), and I refuse to have a PSA test and so does my Uncle (my Dad’s brother), a retired urologist who performed many prostatectomies himself.
You have to perform 48 radical prostatectomies to prevent one death from prostate cancer. Radical prostatectomy is a very morbid and expensive procedure, with a long recovery time, and it frequently produces urinary incontinence and, less commonly, very big time erectile dysfunction. The most common alternative (brachytherapy — an expensive form of radiation therapy) produces (and I quote from a large, important study published in the New England Journal of Medicine) “long-lasting urinary irritation, bowel and sexual symptoms, and transient problems with vitality or hormonal function.” But if I had an elevated PSA, I’d probably be freaked out not to have SOMETHING done. So it’s very easy to “sell” expensive prostate cancer treatment to people who are poorly-served by such treatment. The statistics are that you have to screen more than 1,400 men with PSAs and provide morbid treatment to 48 men to prevent one prostate cancer death. You get lots of false positives, meaning men who undergo prostate biopsies (sometimes multiple), for ultimately no good purpose, which produces unnecessary morbidity. This is why me and my Uncle have opted out of PSA screening. There’s an epidemic of radical prostatectomies going on, increasing numbers of which using very expensive Da Vinci robotic machines, which must be paid for; prompting more screening and more prostatectomies.
I should add that the 1 in 48 “save” rate for prostate cancer treatment are data which came out of a single “positive” study. Other studies have failed to show any benefit whatsoever. So the 1 in 48 statistic is putting prostate cancer treatment in the most favorable light possible.
Very sophisticated people, have gotten trapped in the prostate cancer screening web. e.g. http://www.usrf.org/news/010815-celebrities_CaP.html
Would all of these people have died from prostate cancer, absent screening? Certainly not. Would ANY of them have died? Possibly not, although I don’t have the details of their pathology and clinical stage; so I can’t know this, but, again, only 1 in 48 (at best) men treated for prostate cancer have their lives extended because of the treatment. And at a huge cost to the health care system and at considerable morbidity to the patients.
Now, they probably don’t do this sort of thing in the UK (though they certainly do in France, which has the world’s best health care system, which is one reason why the French, along with everyone else, are having problems containing costs, although they are still much more successful at this than are we hapless Americans). So, this is only one of a great many situations where “rationing” care is actually a good thing for health care consumers (and taxpayers).
- Larry Weisenthal/Huntington Beach
The press, despite their desperate attempts to provide cover for Big Zero, are being forced by reality to slowly dribble out the facts:
The sad reality is that no matter what language is in the bill, and the ensuing law, the exclusionary provisions for illegals will most likely be struck down as unconstitutional by the Courts. The Courts have already established that illegals CANNOT be excluded from any benefit offered to citizens.
Of course the proponents of ObieCare on this board continue to ignore the 800lb gorilla in the room.
Larry, thank you for your thoughtful responses. As a fellow Michigan grad (’64) with a son who is presently a senior (probably hung over from celebrating the win over ND), and a father (’35), I am particularly interested in your observations. I disagree with some of what you say, but unfortunately I have a huge project that must be completed and hence have to work today. I will respond in more detail later.
@disturber: The win over ND was sweet (and exciting)! Go Blue!
- Larry W
I know people that are like President Obama. I’m sure everyone here does. They will tell you how things should work, and then blame you when it does not go right. You never see a written proposal by them. They can’t do that. Doing that would tie them to their ideas and they would no longer be able to blame anyone else.
You will never, ever see a written proposal from Obama on anything. Doing so would take away his one major weapon…blame.
SAVE is useless here in Maine. Our Governor passed a law that prevents State of Maine agencies from asking people if they are residents and legally here in this Country.
That’s why Catholic Charities continues to dump refugees here in Maine.
@openid.aol.com/runnswim: As Larry grudgingly admits the socialist models for health care he cites all have problems with runaway costs. They also ration care and treat the hapless souls with no other option like dirt.
Larry goes on to praise the Massachusetts Model. Here’s the reality:
I am glad to see that Larry has moved on to his other talking points after giving up on the issue of defending Obama for uttering LIES in his speech to a joint session.
Anyone who believes a LIAR will somehow do a better job of creating a government health care system which succeeds where all others have failed really must be sipping the Kool Aid!
We can get “EVERYBODY” to agree on rational healthcare issues that impact us “all” (such as those issues duly noted) and want to do something about it. The problem has been the way the issue was approached by the DNC led congress and later by the President himself…setting it off on a course of partisan political interests and bickering which has only worsened the longer this goes on. They need to scrap this heap and start over. They aren’t “remotely” on the same page with each other, much less forming a broader consensus.
As far as I have seen…the Mass model had one very significant problem…money doesn’t grow on trees. That issue/problem is not limited to healthcare..nor will a new health system solve it. The system was completely overwhelmed and out of money quicker than cash for clunkers.
That quote above and the scaremongering in the Real Clear Politics editorial about rationing and death panels are total BS. I’ve discussed these issues and I’ve discussed the issue of Obama “lying,” and I have neither the interest nor the time to go running around and around on them. Mike “wins” his debates through a dogged determination to be the last man standing. Fine.
The Massachusetts plan was centered around expanding coverage. It has succeeded at this level. The problem has been the cost. But cost overruns have been the worst in the world in the US private health care system. Can you imagine governments raising taxes at 30% per year, the way that private insurance has done in this country? That’s the reason why the citizens of Massachusetts (and everywhere else) are finding their healthcare to be less affordable. And can you imagine the US government getting away with rationing care through the use of closed, opaque panels of businessmen and the doctors they employ? A huge virtue of government-administered insurance programs is their transparency, which just doesn’t exist in the private insurance sector.
Mike loves cutting and pasting lengthy passages from highly partisan op-eds.
I won’t do that, but here are some links, providing a more nuanced perspective, for those interested in more in depth reading:
https://www.tnr.com/blog/the-plank/massachusettss-health-care-success-story
http://www.prospect.org/cs/articles?article=a_limited_health_care_success_in_massachussetts_
http://blogs.wsj.com/health/2008/06/03/sign-of-success-for-massachusetts-health-insurance-mandate/
http://www.online-health-insurance.com/articles/health-news-6-9-08.php
- Larry Weisenthal/Huntington Beach, CA
Did someone mention Medicare?
Meanwhile, the 800 lb gorilla continues to sleep peacefully in the corner of the room.
Exit questions: If Obie has this fantastic “plan” that will solve everything that is going on with Medicare and it’s fraud, graft, waste, abuse, etc….why isn’t he implementing that “plan” now with an immediate effective date?
If these ideas are so super-de-dooper then why do the American People have to wait until 2013 to benefit directly from his brilliance?
@Aye: You keep running the same tired old graph. Why do you refuse to show the graph which really matters: The graph which compares the rise in Medicare costs with the rise in private-sector costs? Medicare delivers a product which is superior in every way, for a lower cost. Total costs are (1) taxes + (2) insurance premiums + (3) out of pocket patient costs. The sum of these three is lower for Medicare insurance than it is for private insurance (adjusted by age/disease, etc.) The only reason Medicare shows those huge deficits is because private insurance raises its premiums by 30% per year, while Medicare can’t raise taxes at will.
Thank goodness for Medicare. Without it, the country would be much worse off, paying for senior citizen care through private insurance policies which would probably cost in the neighborhood of $40,000 per year, or more, per beneficiary.
And graft and fraud are as bad or worse with private insurance as with Medicare. The graft and fraud comes from providers billing for services they didn’t provide or actually recruiting patients to get procedures and other services they don’t need. The only difference is that the government is transparent, while the private health insurance companies are opaque.
- Larry Weisenthal/Huntington Beach, CA
Logging in to play catch up… for a few moments. Larry #7, as usual, you catch my eye… or would that be cyber ear?
Gosh darn… thank you for that elementary civics lesson, Larry. Give a girl some credit of knowing how the process works, eh? So let me return the elementary civics lesson with the same gracious delivery…
Any revenue/appropriations bills *must* originate in the House via the US Constitution. So allow me to provide a link to the House rules for you in return.
It is because any O’healthcare costs money, and is not “deficit neutral” that we all focus on the House bill as the starting point. That pesky Constitution, ya know. But of course the Senate can chip in during the chambers’ reconciliation process… but the very foundation of this is required to be built from a House bill.
BTW… I hear Obama’s WH is mulling writing their own bill to be carried…. wouldn’t surprise me in the least. They did that with the IMAC legislation, the “death panel” of appointees, outside of this specific bill, that no one wants to talk about.
You wouldn’t be fishing for a “lie” vs substitute for Obama’s “intellectual dishonesty” for his campaign speech to the joint session, would you? Such nuance… or PC language for lying like a rug….
Let me get this straight, Larry… you accept Obama’s discussion about a health care bill that doesn’t exist, since none fit his description. Then you give him a pass because there’s no bill that fits his description. Then you further give him a pass for pressuring Congress to pass one of their bill versions by Nov-Dec?
You aren’t getting into any of the prescrip drugs per chance…. are you? This is some loose rules for blind support.
Let me understand this… you are trying to buy insurance against financial failure? Pie in the sky… Not one business exists to prevent personal fiscal failure… just to pad the loss. You are asking to pay someone a fee annually to guarantee against absolute high dollar loss for a very common ailment.
There are alternatives against personal bankruptcy, Larry.
1: You use the coverage you can purchase as long as you can, and the treatments they provide.
2: You pay cash outside that that coverage, or find a private insurer who will… as you demand of your own clientele
3: Ultimately, you become your own “death panel”, usurping that power from a government panel of fiscal management. You decide when you are fighting the inevitable, and at what cost to your family and heirs. At least, in this case, you make your own decision.
No one is immortal, and it is not the job of any corporation to guarantee you hang on to everything you have. Even your homeowner’s or auto insurance is not necessarily replacement costs. And may not cover your every loss. It will, however, put a large dent in it.
What you ask makes me wonder about your mindset. Just who owes you that guarantee?
Larry W… INRE your comment #18… which I wanted to address separately. Let me ask you a philosophical question to see where you come from.
Do you believe that medical providers should be a non profit?
I see that all you have to offer this afternoon is more complaining regarding the graph which clearly shows that Medicare is not as fantastic as you would like the casual observer to believe.
You haven’t presented any facts to refute the accuracy of the information presented…just complaining that it’s true….BUT….
Why don’t you post that graph if it exists?
You also danced around the exit questions about Obie’s grand “plan”…if it’s so great and super fantastic then why not implement it alone, today, with immediate dates of effectiveness?
Let Obie and Congress go ahead and implement a couple of small scale reforms to see how effective they are rather than taking over 15% of the US economy when all the gov’t has is a proven track record of failure.
Why wont’ they do that? Because it’s nothing more than a shell game, that’s why.
Some are falling for it. Others aren’t.
Mike’s A #26… I think, to understand Larry’s “talking points”, is to understand from which perspective he speaks.
Those that get, have been getting, or expect to get “free” medical everything (or what they misconstrue as free) will always be happy. There may be a success in consumer satisfaction in the Romney’care… and Larry does continually take the consumer point of view (aka POV in film language). In one way, this is admirable for a provider… put the consumer’s well being over his own financial survival.
In another way, it does not address the future of R&D for medical advances, of which Larry is also an integral part. I never once… despite my disagreements with him.. fail to recognize he is one of the rare crittters that has devoted his life to “curing cancer”, so to speak. I find it both admirable and fascinating that Larry often projects opinions – not as a professional, but as a consumer.
What is less than admirable is what I see as a lack of foresight. Consumers will always be happy with something for “free”. Especially since quality is relative. I mean, are you qualified to compare living in a million dollar mansion with a trailer if you haven’t lived in both? What you have never experienced, you cannot miss.
But then, nothing is really “free”, yes? And as in the case of Romney’care, Medicare… hang, even some warped Canadians… they do so appreciate “free” care and the release from the risk of personal fiscal liability.
The only problem is, it conflicts with reality. Consumers… happy. Providers… lossing their arse. R&D… down the drain to mediocrity. And often at the cost of the taxpayer.
In my daily business dealings, I am always aware that business entrepreneurs must make a profit. My negotiation goals are usually to find that happy medium to “making a profit” and “making a killing” off of the uneducated.
I want medical providers to be profitable. It is that incentive that leads to advances, and not stagnantation. (is that a word?? LOL). Thus my very direct questions to Larry… a French healthcare plan supporter (who are non-profits). Does he believe that medical providers should be a non-profit industry.
If we can get past this basic view …. ala physicians and hospitals as a non-profit… we might just gain some foundation in our debates.
@mata: First, some data:
http://www.washingtonpost.com/wp-srv/politics/documents/american_journal_of_medicine_09.pdf
You (and most people) fail to understand just how vulnerable all of us are to crippling health care costs. These are not lightning strike catastrophes: these are common, everyday occurrences. No one “owes” me anything; but I do have a brain. I look around the world and I find that citizens of every other Western democracy don’t need to fear personal bankruptcy owing to health care costs –only in America, literally.
So why should we Americans not use our brains, pool our risk, and insure ourselves against this calamity?
As I tried to illustrate, the problem is that I could not find catastrophic health insurance which would pay for the most likely catastrophe (cancer, with its attendant medications) at any cost. And I’ve currently got an uninsured kid. Despite my ability and willingness to pay premiums.
If I could find myself in this situation, then anyone could. And it’s unnecessary. All we have to do is join the rest of the civilized world.
I’ll let you have the last word on Liegate.
- Larry Weisenthal/Huntington Beach, CA
@openid.aol.com/runnswim:
Larry, you live in a liberal utopia land out there on the left coast.
Isn’t your good state responsible, ultimately, for the lack of choices that you have vis a vis health insurance?
Your state is doing that to you…and to your fellow man as well. Seems that you should be looking to your State Legislature to lift competition limits and allow you to go across state lines to make buying decisions.
In fact, that’s something that all 57 of our states should be doing.
Get the gov’t off the backs of the health insurance industry and allow them to compete nationwide.
Get the gov’t off the backs of the small business owners (like me) and allow us to band together with other small businesses to form buying pools with greater negotiation power. Let small business purchase plans across state lines as well.
The gov’t is the root of many of the problems that we see with this issue. Greater, more intrusive gov’t involvement and more extensive mandates isn’t going to solve anything…unless, of course, driving people away from private insurance and onto the public option is their ultimate goal…which is becoming more and more clear to those who are paying attention.
@mata:
Of course, but here’s what American physicians earn:
http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm
You’ve written about Medicare squeezing doctors. That’s true, and it’s also true that medical school expenses are considerable (the average new physician starts out her/his career with a $150-200K education mortgage), but it’s also a fact that med school applications have never been more competitive and there would be no problem at all attracting great students, were compensation levels lower.
I don’t want to exaggerate the impact of the physician component of total costs; I think it’s something like 10%. But, still, it’s a larger component than malpractice.
Larry Weisenthal/Huntington Beach, CA
(gotta go on mini-sabbatical for at least the rest of the day; enjoy the penultimate Sunday of Summer).
From Larry’s comment: “Aye: You keep running the same tired old graph. “ Has anyone else noticed that Larry completely dismisses nearly ALL of the points so many of us have been making these past months? It’s the same “my way or the highway” style of bipartisanship we have been getting from the Liar in Chief, Obama.
Sorry Larry, but in this Republic, being in a temporary minority in the legislative and shut out of the Executive, does not make us wrong. And in this case, it’s exactly the opposite of wrong.
Unless you can show me concrete proof that a singlepayer system is successful in meeting the needs of ALL it’s citizens without rationing or decrease in survivability from major disease and at a stable, predictable cost, then you have no basis of fact upon which to rest your opinions.
I have no idea where some people get their info. 40 to 50k a year tuition is “standard” fair for NYU under “any” program. MOST students these days, regardless of major or degree program, leave the university with massive debt. Malpractice insurance rates depend on what your specialty is.
Checked the rates for OBGYN lately?
Course, we can always save money using midwives birthin at home. Hell, it was good enough for our forefathers…why not now? I bet you could find some statistic somewhere…that shows that 90% of the cost of a hospital birth is unnecessary in “most” cases. That if we didn’t have such care for births, probably “most” babies would be born just fine. Maybe a few would have complications, etc., perhaps a few deaths that otherwise might have been prevented by being in a hospital when things when south, etc. It seems your question is…is that worth the extra cost??? YOu bet your ass it is…..when its YOU, your wife, or your baby we are talking about.
I can just see some Obama czar…lets see..for the price of one liver transplant, we could give primary care to 1000 illegals. Besides…you drank anyway.
And then…as you said….so what if a few people die from prostate cancer….that might otherwise not…the ratio of benefit to dollars doesn’t make the cut for doing the tests and screening on a widescale. The question is…who do you want making those decisions?? Do YOU want to make that decsion based on an agreement/contract between you and a private insurer and how much you are willing to pay to get the coverage and treatment you want to have?? Or do you want someone else deciding that for you, and distributing it based on the cost/benefit ratio between the care you want/need and the benefit it has to the rest of society as a whole?
And given those examples…which would you rather be….bankrupt and alive? Or dead? And who do you want to make “that” decision?
@Mike:
I’m not dismissing your points.
I only make these points.
1. “Death panels” is scaremongering
2. “Rationing” is scaremongering
3. The concepts that private health insurance provides superior service, “rations” less, or provides superior cost control are demonstrably false.
4. “Single payer” is a straw man. No one is proposing this as a serious plan for consideration. It will never get passed into law, no matter what the secret wishes of Barney Frank (or even Barack Obama). What we are headed for is a French-style system, with a basic level of care provided for everyone, with individual options for supplemental (or replacement) private insurance. This will take many years to achieve, but the presently discussed plans are a concrete beginning, and these plans are supported by the (conservative) American Medical Association, representing a large segment of America’s doctors.
And (how’s this for a statistic) 59% of the nation’s doctors would favor a single payer, “Medicare for all” system. The people in this country who know the health care system best agree that the current system is a disaster. I happen to be one of them.
http://www.prospect.org/cs/articles?article=the_doctors_revolt
- Larry Weisenthal/Huntington Beach, CA
@DC:
You miss the point: you have to mutilate 48 men to prevent one death from prostate cancer. I “opt out” of this “opportunity” and so does my uncle, a urologist who’s done lots of prostatectomies, himself. I can’t imagine that anyone would want to be screened, knowing this statistic, yet millions are, because they are talked into it by their doctors, who have an inherent conflict of interest in recommending it. And the 1 in 48 is best case scenario; other studies have shown no benefit whatsoever.
And, as I keep saying, these decisions are already being made — by private insurance companies more than by Medicare. Although Medicare’s overall costs are still lower, they are rising faster than in the private sector, chiefly because Medicare rations less and is generally more flexible in its coverage of state of the art procedures, tests, and drugs.
Rationing is already here, and it’s more a private than public sector phenomenon. And it’s inevitably going to get more prevalent. Only I’d much rather have the “rationing” decisions to be made in the transparent public sector, rather than in the opaque private sector.
As for malpractice reform: It’s been done for 30 years in here CA and for several years in TX and it hasn’t done squat for reducing health care costs. It’s worth doing, but it won’t make a dent in health care costs, even though this is one of the central pillars of GOP so-called health care “reform.”
- Larry Weisenthal/Huntington Beach, CA
Love the pic of O’Liar, but I think the nose is a bit short considering all the lies he’s told. I know I have lied in my lifetime, but I can guarantee that O’Liar has uttered more lies in the last 9 months than I have in my almost 70 years on earth. What does that say for the people who profess to love him, honor him, and obey him? Looks like they were made a fool of.
My opinion
Madalyn
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Larry, I think it’s you who is missing the point/difference between negotiating with a private company over your coverage/care or a given cost on the basis of their profit verses your health, and having those cost and other determinations set by government at given level based on balancing your care/coverage or cost of a given procedure with the rest of the nation and its cost/benefit to society ratio.
As I said before, having babies delivered in hospital rooms or doing c-sections to avoid risk/complications (or even in some cases by election), isn’t necessary either and the cost to death ratio is similar to what you are talking about. Most babies would live…even if delivered at home with hot water and towels. That does NOT however mean that money that one has spent on “mutilating” (your word) young women with C-sections, abortions or other procedures INSIDE A HOSPITAL instead of in a back alley somewhere, or pre/post care is somehow pointless or wasteful just because you didn’t get an infection, or had other complications as a result.
I’m not a republican but even “I” know that 150 to 250k a year in malpractice insurance for the people who put your to sleep or deliver your baby adds to the cost of doing business. And further, ANYONE who has ever dealt with gov redtape (like when they change one friggin code and it takes 4 years to get it worked out) cringes to think about gov run healthcare. Furthermore, nobody is going to go to medschool and put in the time and money to do what it takes to become the massive amount of doctors, etc., we are going to need without MAKING MONEY.
We don’t live in a socialist country (…..yet).
@DC:
In the first place, that’s not the way it works with single payer government insurance (Medicare). I’ve explained this extensively in the past. It’s a totally transparent process, with input allowed by everyone, and coverage decisions are based on medical efficacy (not cost effectiveness) and Medicare is much more flexible with providing coverage than is private insurance, and the appeals process with Medicare is much more patient friendly, with the patient’s ultimate trump card being his congressman.
You are talking about some theoretical future possibility — a British “NICE” style system, which does ration on the basis of cost-effectiveness. This could, in theory, be done by Medicare at any time, but it won’t, because Medicare is transparent public and the hue and cry would be something awful. And the British system is unique and in no way a model for US health care. British physicians work for the government. British hospitals are owned by the government. This is not the way it works in France and other European countries, which are better and closer models for where the US is headed.
Let’s say, however, that at some point in the future, health care expenses are so great that cost effectiveness does come into play in payment decisions. Firstly, it would be an utterly transparent process, and wouldn’t be non-medical bureaucratic bean counters behind closed doors. Secondly, anyone troubled by such things could just buy private supplemental insurance. Thirdly, it’s very likely that the private companies will do this sort of thing in the future themselves. In fact, they are already doing it now, to some extent. They are more lenient with approving inexpensive drugs and procedures than they are at approving expensive drugs and procedures. A great many plans mandate the use of older drugs, which are less effective, in some cases, than newer, more expensive drugs. Medicare is often much better at paying for the newer drugs. Certainly if you get cancer, you’d have an easier time, in general, getting approval for the form of chemotherapy your oncologist wanted to prescribe than would private insurance, in cases of “off label” indications, which is about half the chemotherapy prescribed in this country.
The point is that the rationing thing is theoretical scaremongering.
With regard to malpractice reform, another beautiful theory ruined by an ugly fact. Of course OB-GYNS have huge malpractice costs. And they aren’t going to come down very much. No one is proposing a cap to actual damages — medical care plus lost earnings. The only thing talked about being capped are pain and suffering awards. This tort reform has been a reality in California for 30 years and hasn’t brought down health care costs. It’s worth doing; but it won’t make a dent in the health care budget; i.e. it won’t “bend the curve.”
I really don’t like you taking what I said about “mutilating” patients and twisting it. I NEVER referred to Cesarian sections as “mutilation.” I was referring to radical prostatectomies and I stand by my words, in this case.
And, for your information, there is less red tape and aggravation in dealing with Medicare than with Blue Cross, Aetna, et al. This is one of the reasons a substantial majority of American physicians are in favor of a single payer, government administered system (link/reference above, #40).
Not correct: There are huge numbers of highly qualified would be med students who would jump at the chance to work for a measly $150K per year, as opposed to the $300K per year which adds to health care costs today.
- Larry Weisenthal/Huntington Beach, CA
Larry,
OF COURSE it’s not the way it works with single payer gov insurance…because we haven’t destroyed private insurance companies yet via mandate/law yet and turned into socialized medicine. You can’t have “single payer” insurance without first destroying private insurance coverage (which of course is what Obama says he “doesn’t want to do) while other recordings of him says it is what he wants to do….while even recent media apperances of DNC figures suggests that IS what they are aiming for.
You are getting ahead of yourself….and showing your slip.
Yes of course….in “Obama’s economy” (I can all it that? Since Bush’s war was declared after 9/11 (ie…on his watch..despite all the missteps before) ANY job that pays ANY money is worthwhile!!!
in fact…if you have any job…at all, that pays anything….you are lucky!@
Sure, I guess some people who might have been business majors, or art majors…might just sign up for 10 years of school (with no scholarship…not less), just so they can make the same money somebody else did with just an under grad degree.
Yep….the smarting of america. Is that “smart-power’? Or smart=power”?
Yes…you dont’ like to hear your own words (mutilation) thrown back to you in the same strawman argument you presented.
Please!!
Oh…because some cost/procedure if overused..unnecessary, expensive, and may cause harm to patient…and you object??????
Its the same argument you made!!!
Lastly…”anyone” who believes the gov is “transparent” …has Lost their damn mind. Particularly THIS admin…who’s had to hire “czars” to bypass the congressional vetting process…cause they dont’ like to pay taxes….they just like …”free shit”.
health care is a “right”. How about something more basic….somewhere between health care and freedom of speech….like “food”. Or shelter. Is that a “right” too? I mean….that also is a reason people are unhealthy?? And it could absolutely affect your health/outcome for any health issue.
if you think about it…health care is further down on the list. So,…what about it? Should we also guarantee good food, and a decent house to every american (and non-american..given the current bill)?? You want to buy me a house? Make sure I eat right everyday?
Hey…I’m all for it bro!@!! Free food!, Free house!!! Free healthcare!!!
AND its absolutely true that if I had all these things…I’d not be struggling like I am now!!
Surely…I’m struggling more than those who make more money than me?? They can afford to help me??? No??? We are all in this together!! Share the candy bar…and we are all comrades?
Okay, Larry… INRE our base foundation from debate, we are getting somewhere. You and I disagree from the start that medical providers be non-profit “civilian govt employees” vs private enterprise entrepreneurs. This comes from a foundation of you believing health care is a “right”, and me believing that health care is a “service”.
And perhaps, that comes down to even more of a basic… is it up to the taxpayer and the government to extend your life with medical advances you don’t wish to pay for? I say no. But then, I am at peace with the “my ticket is up” concept… sans man and the AMA’s intervention.
Now that we know from where we both start in philosophical belief….
Would you like to address how many of those “new applicants” will be going into specialty practice, as opposed to the “primary care” practice? And is more cost affordable for those genuinely in need? I read that most are headed for the big bucks specialty biz.
You are assuming equality in preservation of life between those countries you admire, and the US, Larry. Other countries recognize “vunerability”, and do not provide care that our insurers don’t provide with catastrophic illness. For heavens sake, you make it sound like other countries give them every experimental drug, or every “maybe it will work” surgery to prolong life. What I read about catastrophic care in other countries is that the options are less vast, the wait long… if you live thru the queue at all.
What you are willing to accept is to put that decision of what can, or will, be done in the event of your (and mine and all around you) catastropic illness into the government’s hand … should they be capable of financial dubious miracles. And all so you can have the mental security of avoiding bankruptcy? Strikes me as a bit extreme. Especially coming from a guy who believes he should be functioning a non-profit.
Ya know, if someone has the cash, it’s up to the individuals to pick what they want for treatment and how long they keep bucking the inevitable.
But please don’t try to convince us that government care in other countries provides superior extreme treatment options. You either fit the “standard/basic” bill of care… or you go else where… or you pay thru the nose where the doctors are advanced enough to know something more than the usual suspects.
It’s interesting you talk about preserving your personal assets and wealth, demanding an insurer “risk” it on you with common cancer ailments. But, on the other hand, you don’t want doctors with advanced knowledge the opportunity to stay financially afloat to offer that “advancement” another day down line. What your propose is not stellar and advance care, but basic care – sans advancements or experimental – offered to everyone.
There’s two problems with this “non-profit” business you do not acknowledge.
First… that when you offer “basic” care to all, it is a standard that continually morphs… downward. And is substandard.
Secondly… that even acceptioning minimal advancements for “universal care” as a substitute, it is still a losing fiscal battle. You can make note of this with your treasured icons… the French
@MataHarley said> “I read that most are headed for the big bucks specialty biz. “
They won’t be after Obama gets his way. There will be little financial incentive to do so and the risk of lawsuits, which is much higher in a number of specialties, will be just as great. And, we’ll be having even longer waits to see those specialists just as they experience in Canada
But this doesn’t mean there will be more primary care physicians available to treat patients. Dumping 30 million new consumers into the system will make it difficult to get an appointment.
This fantasy that Larry and his fellow libs have that somehow THIS TIME, government will do this right when there is NO past experience when they have is truly frightening.
Larry and friends seem to be oblivious to the unintended consequences of good intentions.
Larry W, INRE Laurin’s denial of coverage for pre’existing…. She’s a Yale (or Harvard) grad, yes? Is she not working in a career (other than English Channel training…) and have access to a group plan? That cannot be denied for more than a exempt period of up to 12 months.
And the pre-existing bit would disappear if feds and the states would allow for individuals to form “groups” to have access to group plans. In other words, every individual would have at least one or more “groups” to choose from. This doesn’t need to be tied to employers either.
Lovely girl, BTW.
Thanks, Mata. Laurin was a Harvard swimmer; accepted for admission to the U of Colorado Med School; taking a year off to swim the English Channel and continue with some very exciting work she began with a stem cell group at Harvard who moved to continue the work with a start up biotech firm in the SF Bay area http://izumibio.com She’s got wonderful, employer-provided insurance. The (hopefully temporary) problem is the other daughter, a recent Yale econ grad (and rower, who’s Yale “4″ took 3rd at this year’s NCAA Div I champs and then won the Senior Division at the Women’s Henley outside of London in late June. Not the greatest year to be an economics graduate, she’s deciding what she’s temporarily working in our family lab business (we don’t have group insurance; just individual coverage). Had had some sports injuries, now resolved and unlikely to recur, as she’s not training at the level as before. I’m sure she’ll get it resolved, but the denial was unexpected and it’s so freakin’ ironic that I, of all people (surely one of the world’s most paranoid people when it comes to health insurance, which I view as important as food, clothing, and shelter), should find a first degree family member among the ranks of the uninsured. – LW/HB
@mike:
I’ve got one word for you: Medicare
Curt might have two words for you: County Sheriff
etc.
@mata:
Your post (#50) mischaracterizes my position. Just about everyone on this blog thinks that, in order to be supporting health care reform, one needs to be a socialist/marxist/whatever. For goodness sake, you’ve got 59% of the nation’s doctors preferring a single payer, government administered system over the mess we’ve got right now. They don’t favor this because they are socialists/marxists and want to be “government employees.” Neither do I. Read the article I linked about it and find out why they/we feel this way.
I don’t think that health care is a “right.” I think that free speech is a “right,” along with the other “rights” provided by our constitution. There is no constitutional “right” to public safety, but we do provide national defense, police protection, and fire protection. There is no “right” to a decent education and certainly not to college and graduate level education, yet we do provide these, because we recognize the advantages to our society in doing all the above things.
The elderly have no “right” to health care, yet we were wise enough to establish a system to provide this. An enormous amount of the total health care in the USA is provided through Medicare; I’d wager in cancer, alone, it’s close to 50%. I think that, of all health care spending in the USA, close to 50% is government-paid. 70% of the private hospitals are non-profit. Studies have shown that for-profit hospitals often provide inferior care to that provided in the non-profits. But virtually none of the doctors are “government employees,” any more than the employees of Boeing are government employees.
The point is, the health care system is already half-”socialized,” if you want to think of it in those terms. But our half-baked system is an administrative nightmare for physicians and hospitals, and the lion’s share of this nightmare is caused by the private insurance sector. Pre-authorizations. Restrictions on which drugs can be prescribed. Payment denials. And then there is the problem of the uninsured. And, for the rest of us, there is the specter of personal financial disaster which is only a diagnosis or accident away and against which it is currently impossible to insure. One can buy fire insurance which provides certain protection against fire losses; the irony is that it’s virtually impossible to find health insurance which provides certain protection against financial losses from health-related catastrophes.
What I personally favor is a gradual expansion of Medicare to cover increasing numbers of the population with a very good, basic level of service, with a robust system of private insurers to provide supplementary coverage for employers who want to offer (and for people who want to obtain) a very high (“concierge”) level of service. I believe that this is the best way to contain costs, provide near universal coverage, and to improve entrepreneurial medicine, through fostering competition. I think that principles of market economics can apply at the concierge level of medical service, but that they’ll never apply at the basic level of medical service.
When are we going to have a thread ranting and raving about our socialized sheriff’s departments?
- Larry Weisenthal/Huntington Beach, CA
@DC: #47
I was merely making the point that the rules of market economics don’t apply to medical care, because “buy” decisions are made by the “sellers.”
Let’s take a poll of men on this blog:
O.K. Guys, how many of you would have a radical prostatectomy for a 1 in 48 chance – at best – that it would prolong your life? There’s a much greater chance that taking one baby aspirin per day would prolong your life (that’s been known for years). How many of you are taking one baby aspirin per day? Cutting out red meat has greater than a 1 in 48 chance of prolonging your life. How many of you are willing to cut out red meat?
But it never gets explained that way. Because the people who do the explaining are the same people who get paid for doing the procedure and who don’t get paid for counseling against the procedure.
Babes in the woods. True believers that the free market can do no wrong.
And, in an answer to another rant, Medicare is totally transparent/open doors. Private medical insurance companies are opaque and closed doors.
- Larry Weisenthal/Huntington Beach, CA
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Wilson was correct!! No apology necessary either.
Larry,
I never said that the free market can do no wrong. It “is” our current system however (until we become socialist). There are solutions to the problems you mention and there are plenty of things we “can” fix without moving to a government run system.
There are plenty of babes in the woods here in america who believe socialism, communism, etc. are all better models for everything.
@openid.aol.com/runnswim: Medicare is going broke and has ALWAYS exceeded the costs that politicians predicted Larry.
You’ll have to do better than that. Especially since Obumma wants to CUT Medicare for seniors.
NEXT!
@Mike: Medicare has done a brilliant job at providing universal care of unsurpassed quality and consumer satisfaction at a total cost of substantially less than private health insurance (medical condition and age-adjusted). The reason it’s “going broke” is that advances in medical technology are running amok and Medicare can’t raise taxes at will, the way that private sector insurance can raise premiums at will (case in point: recent 30% PER YEAR rise in insurance premiums with more than doubling since the Bush 43 inauguration).
With respect to “gutting” Medicare, that’s just more scaremongering.
There are only two ways to control costs: (1) Raise taxes or raise premiums (either is an equivalent drain on our personal incomes, only private insurance increases are greatly outpacing what would be need to restore Medicare solvency) and/or (2) cut back on payments (e.g. as happens every day in the “rationed” private sector, where tests, procedures, drugs, and treatments are routinely denied on the basis of “no medical necessity” — in the eye of the insurance companies, who substitute their medical judgment for those of the patients’ own doctors).
- Larry Weisenthal/Huntington Beach, CA
More liberal propaganda from larry. Larry, I don’t deal with medicare the way you do, but I can tell that from my experience people are not happy with it.
I know responding to you is a waste of time as you are so deep into pathological denial you’ll never come back. You’re too busy watching a “legend” being made before our eyes.
Shouldn’t you be crashing thru a wall somewhere shouting “Oh Yeah”?
@Hard Right:
HR,
Larry doesn’t deal with Medicare at all….it was so wonderful and fantastic and super-d-dooper he had to opt out because of its’ greatness…..
Heh.
Aye, color me shocked. A trademark of liberals. Required for thee, but not for me.
While I rip on larry, I have to admit I really don’t hate him. He doesn’t seem like a bad guy, just waaaaaaaaaaaaaaaaaaay off into liberal fantasy.
Back to Medicare. In the last couple of years I’ve watched it cover less and less and talked to those struggling with the changes. They can put out all the polls they want because if what I’m hearing from the people using it is any indication, then Medicare is hardly as wonderful as larry claims.
My posts seem to be winding up in the filter.
You’re right….I’ve had to fish you out several times now.
I’ve emailed Curt.
Kind of funny considering I’m being nicer than usual . Is that a sign from the spam filter gods?
Thanks.
My father has received Medicare coverage for (1) a quadruple bypass, (2) stomach cancer, and (3) chronic biliary obstruction from cholelithiasis, along with more routine matters, such as cataract surgery. My mother received Medicare coverage for giant cell arteritis, cataracts, and lung cancer. My sister (an MD) has received Medicare coverage for 6 years of ovarian cancer, including 6 major operations and 6 different forms of chemotherapy. Care and payment have been, in all cases, explempary.
In the case of my Mom (a resident of Kentucky), I had her go to NYU in New York to receive her primary lung cancer surgery from the thoracic surgeon who is the chief author of the most important textbook on lung cancer and then to Loma Linda University in California to receive proton beam therapy from the only such facility of the country which can treat para-spinal metastases with proton beam. Then she received her chemotherapy from the best oncologist in her metropolitan area. There were no geographic or “provider network” limitations, as there would have been with private insurance. No preauthorizations required. I doubt seriously whether any private insurance would have paid for her “experimental” proton beam, but Medicare did and it was brilliantly effective.
I had my Dad fly from Florida to California to have an 80% gastrectomy performed by a UCLA surgical oncologist who is one of the few surgeons to lecture on the topic of stomach cancer in Japan, the world leader in stomach cancer. He had his 4 vessel bypass performed by a cardiac surgeon who trained with DeBakey and who did a state of the art “beating heart” (off pump) 4 vessel bypass.
My sister has received her surgeries and chemotherapies likewise from the best doctors around, at the best facilities. No preauthorizations required. Medicare paid for certain (effective) chemotherapies which would have been denied for coverage by Blue Cross.
I previous provided the citation for the peer reviewed study of patient satisfaction with Medicare, compared to private health plans.
- Larry Weisenthal/Huntington Beach, CA
Larry, with the grim Family history of medical issues it is a good thing that you are an MD.
I am very sure that taxes must go up to support a patient load of 40 to 30 k folks that are lacking insurance but get treated anyway. I am hoping that more folks take an interest in medicine and get a good education because we are going to need easily a thousand more Doctors to cover the load. Otherwise there will be rationed care. The old basic supply v demand thing that must be considered.
Well, medical history is grim, but medical care has been outstanding. My Dad (stomach cancer, 4 vessel bypass, biliary obstruction, cataracts, etc.) is now 96 and set a world age group record in the 200 meter backstroke and had the best times in the nation in 5 other swimming events in the past year. He’s meeting us in Dover, UK in 2 weeks to go on the boat with us which accompanies his granddaughter’s attempt to break the women’s English Channel swimming record. My sister is currently in complete remission after more than 6 years of battling stage 3B ovarian cancer. She travels all over the world and is doing great, thanks to great medical care. Even my late mother enjoyed 22 months of complete remission of stage 4 non-small cell lung cancer before dying of brain metastases (the drugs don’t get across the blood brain barrier very well). During this time, she got to attend a college graduation, the wedding of a son (my brother), and several holidays and birthdays, as well as taking 2nd place in a Las Vegas slot machine tournament and getting a free trip to Atlantic City for the world champs.
I truly believe that, with the usual constraints of Blue Cross, none of them would have done as well. I credit Medicare (plus great doctors) for their comparatively good fortune, given that they had the bad fortune to have the illnesses they did. Just as a theoretical consideration, had they not had Medicare, I’d have still sought to have them get the treatments they did, but it would have been a horrendous expense, which would have probably bankrupted the typical patient of average financial means.
- Larry Weisenthal/Huntington Beach, CA
Despite all the claims that I’m a Kool-Ade drinking socialist, it turns out that I’m squarely in the mainstream of American physicians, when it comes to health care reform.
Fully 63% of us (nearly 2/3 and well above the 60% filibuster proof majority) favor health care reform and favor a public option.
http://www.reuters.com/article/GCA-HealthcareReform/idUSTRE58D67120090914
This is one of the main reasons why health care reform will pass. The people who know the health care system the best know best what’s wrong with it and how best to fix it.
- Larry Weisenthal/Huntington Beach, CA
My comment on the breaking news story below went to spam:
http://www.reuters.com/article/GCA-HealthcareReform/idUSTRE58D67120090914
63% of American doctors favor health care reform including both public and private options (just like me).
10% favor public only.
Meaning 73% favor either exclusive public or mixed public/private options
And 55% would favor expanding Medicare (i.e. “public only”) to cover down to age 55 (down from 65, where it is today). Why would doctors want that, Mata, were they losing money on Medicare patients, as you assert they are?
Only 27% favor exclusively private. These are disproportionately surgeons (e.g. like the ones pushing radical prostatectomies in a situation where you have to do 48 radical prostatectomies to benefit only 1 patient).
- Larry Weisenthal/Huntington Beach
Wow, this is absolutely huge; it will be a game changer. No longer will the Party of No be able to assert that it’s only Obamamaniacs and socialists who want to get this done. Read all the stories flooding Google News right now.
Here is the link to the full text NEJM article: http://healthcarereform.nejm.org/?p=1785&query=home
And, for e.g. (from Newsweek):
It’s not a Democrat versus Republican thing. It’s an American thing. Americans will recognize that Obama is just trying to do what the doctors who provide front line health care think should be done. And they will recognize that efforts to torpedo this are simply selfish partisan politics.
Watch and see. Filibuster-proof majority, for sure. This provides all the “cover” the moderates need.
- Larry Weisenthal/Huntington Beach, CA
Link to NEJM article:
http://healthcarereform.nejm.org/?p=1785&query=home
Read all the stories on this currently breaking on Google News. This is a game changer. It provides all the “cover” the moderates need. Filibuster-proof majority.
LW/HB
Link to full text of NEJM study on where American doctors stand on health care reform:
http://healthcarereform.nejm.org/?p=1785&query=home
@openid.aol.com/runnswim: You think respondents being paid to participate in a mail in survey has the same validity of a scientific public opinion poll?
Sounds to me like you are getting desperate Larry.
That’s how medical studies work, Mike. It’s long established precedent. Docs are busy people. They are always compensated for providing data for research studies. I’ve done the same thing, with my studies, requiring follow up. Provided compensation for time taken. The NEJM is universally acknowledged to have the highest publication standards of any peer review medical journal in the world. Unsurpassed credibility.
But that’s OK. Believe it or not. It’s game over. Filibuster-proof majority. All the cover the moderates need.
And the big winner is all of us. Even you, Mike. Which I predict even you will acknowledge, some day. And today was the most important day in the process.
Historic.
- Larry Weisenthal/Huntington Beach, CA
Reply to #71 to spam.
Prior response still hasn’t been dug out of spam. Will try again.
The New England Journal of Medicine is universally acknowledged to be the most prestigious medical journal in the world and to have the highest publication standards. It is, if fact, customary to compensate physicians for providing information of this type. I have done this myself (provided compensation) in order to obtain follow up data in clinical studies.
This study is a game changer. You’ll see.
- Larry Weisenthal/Huntington Beach, CA
@openid.aol.com/runnswim: Put down the crack pipe Larry.
A paid mail in survey does NOT have the validity of a scientific opinion poll no matter WHO publishes it!
Besides, the number of so-called “moderates” is misleading. My bet is that more than half of them are liberals and lying about it.
If this is the best you can do, why bother?
Game changer my ass!
I’ve just finished reading the whole survey, including the supplemental PDF.
Here are my findings:
The doctors were all AMA members. Which are not even 35% of all doctors.
None of the questions had anything to do with Obamacare.
There was only 3 questions.
Less than half responded at all.
More than 3/4 of the respondents are Liberals.
They were paid.
This survey has nothing to do with the topic at hand.
The use of this survey is a red-herring argument, and a trained oncologist should know better.
@Patvann: Thanks for the backup. But it won’t stop Larry. Once he gets a talking point into his head, any information to the contrary gets pushed out.
I’m used to it by now. Don’t ask him about global warming… He thinks he’s an expert on that too!
@Mike’s America Who loves ya baby?
I’ll listen to him if he wants to talk Malignant Melanoma (Wifey is 3 year NED, stage 3) Or the perfect butterfly stroke (Santa Clara Int SwimClub 1974-79)
Aaaanywho…
There is also no word AT ALL about 60 votes, let alone the fact that there are not 60 voters.
One happened to have died recently.
Bird won’t vote for it in it’s present form, and is usually too sick to show up.
2 are Independents, and Lieberman isn’t sounding too enthusiastic.
That gives the Bill 58 at the most. (With Bird and 1 Indy)
The only thing on the move right now is the Senate leadership mulling over if they want to shove it through using parliamentary tricks (reconciliation) , but most members know that that would be political suicide.
Obama has signled that he’ll let Congress kill the Public-option part, but that still leaves a POS for a Bill. The whole thing needs to be scrapped.
Oh PLEASE bring up Glowbull wormining! I’m MORE than ready!!!
Whoa there, pardner… “absolutely huge”?? From your Health Care Reform blog of the NEJM link above:
991 participants. In 2006, the Bureau of Labor statistics had about 633,000 physicians and surgeons in the US. Presumably more in 2009… perhaps not. Let’s play with the 2006 figures as worst case scenario.
That means the “absolutely huge” news you tout is a poll of one-thousandth of a percent of all the physicians and surgeons holding jobs in the US prefer a mix of private/public option.
Then there’s the Reuters report you linked citing another poll of 2130 respondents. Wow… that’s an improvement… up to three thousandths of all the 2006 doctors/physicians.
Some “game changer”…. but I can see you will continue to demean the public’s opinion as irrelevant, and spin it as game-set-match.
You wouldn’t be ignoring that only 10% said they exclusively wanted public options in the 991 participants’ poll, and only 27% in the 2130 participants poll… which is what will be left when the feds destroy most the private insurers by cheaper coverage with less options.
Do they believe Obama’s promises, misrepresenting the House bill, and babbling about a bill that doesn’t exist? Are they aware of the oft stated quest for single payer by not only Obama and Rahm’bo, but most of the Dem leadership in Congress? If you’ll remember, it was predicted that 50-75% of the US population would end up on the public option. Doesn’t leave much privately insured to support the underpayments to the medical providers, does it, Larry. And works quite well with Obama’s vision that single taxpayer will take multiple steps.
Doesn’t sound like these physicians would approve of that goal.
Oh wait… I forgot you believe the medical profession should be non-profits. Oh wait again.. you said I “mischaracterized that. Did I?
ummmm… not sure what I misunderstood about “of course”…. But I digress. Back to your poll of 991 doctors, or one thousandth of all physicians and surgeons. (I notice they didn’t ask any medical facility owners in either of these polls. Wonder why?)
Then, of course, there’s a high aversion to cost effectiveness data that Congress slithered thru in the dark of night via another bill no one read – the stimulus/ARRA.
I guess they also missed the reality of it now being law while busy with their stethoscopes and scalpels. As you said, they are busy guys/gals. Evidently too busy to keep up on the specifics, so they tend to listen to “just words” instead. My guess is they, like Obama and Congress, didn’t read HR 3200 either.
Aren’t they in for an ugly surprise when the bills don’t match the promises?
I say you are premature to call checkmate here. And worse yet, it’s offensive that you are ready to end the game based on these polls. I don’t care if you’re the Surgeon General… you haven’t any more authority or voice in this than I, or any other citizen does. And far more “participants” than your poll respondents were in the streets of US cities all over America on Sept 12th, saying something completely different. And many of them HAVE read the bill.
As for your theory as to why Medicare is going broke… bunk. You might want to remember that the government is collecting cash for Medicare from every tax payer’s paycheck… and they can’t support the small percentage of the population on medicare now. Considering there’s no cost reform in these bills… the real ones, not Obama’s imaginary bill… that’s not likely to improve. In fact, it requires the “willing suspension of disbelief” to swallow that you can throw 50-75% of the population on a similar program, and make it fiscally sustainable.
But here’s my biggest bone of contention with you.
The country “paying for senior citizen care”?? Larry, your parents, you, my parents, me… we’ve been *paying* for medicare since 1965. We’ve been paying it forward for care denied to us until we reached a certain age. Those that are really shafted are the ones who die at 64… pillaged for the duration of their life, and unable to get back some of that highway robbery bootie. What your kids have put into Medicare wouldn’t amount to a drop in the bucket. You make it sound like some charity when, frankly, all Medicare was… and is… is yet another government ponzi scheme like Social Security.
I want my cash back. Period. And I’ll buy private insurance. Ooops… the government’s already spent it. No, make that blew it like a spoiled rich kid running amok on Daddy’s credit card in Bloomingdales.
BTW.. had to laugh listening to Mark Levin today, calling you and those like you, out on your Obama protection talking points. “It’s not his bill”. LOL Yes, good cover for his arse. Amazing to what extent the blind faithful go to have Obama’s back. This POTUS wants it all. When the fiscal disaster hits the fan, he’ll blame it on Congress. But for a few years, if everyone is in “free health care” euphoria before the bank breaks, he’ll take credit and retire from the WH in glory… so he thinks.
But Obama can’t straddle fences forever and his visions for a remade America have consequences. History has far more patience for legacies. And between quadrupling prior national debt in under a year, seizing control of banks, auto companies and dictating salary to private industry, shoving thru cap and trade and health care atop an obscene Omnibus, Obama’s is to be the destruction of the US economy. Then I’ll be happy to say, it’s your country… not mine. Show me to the death panels.
BTW, Larry… INRE your rower daughter now working at Weisenthal. You say you, as an employer, do not provide insurance. Obviously you know you’ll be mandated to do so, and my guess is you… like any P&L conscious employer… will opt for the cheaper public option if available.
My burning question is, why aren’t you seeking an avenue to be part of a group plan, instead of forcing yourself and your family into individual care? You have to recognize the obvious benefits of a group plan, yes?
I might also add that as an employer in the medical provider world, you tout one values version, and behave in a different way. You refuse Medicare patients and ceased being a participant while you get all slobbery over the greatness of Medicare. And you don’t provide your own employees with health care… especially since a group plan could not deny your daughter pre-existing for longer than 12 months max. Very weird.
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Boy did us Democrats show you haters a lesson or two. See how we manipulated you into staging a one million + march in DC?
Ha!!!!!! Got you there you militiamen.
Now it looks like you finally forced us to compromise even though we tried to bend you over a barrel and force our legislation down your throats.
Damn! Did we ever get the best of you.
Now your base is reinvigorated and we are on the defensive.
I hope you learn your lesson that I am playing you guys like a violin…
@Mata:
I’ll address the above in this post and your comments about the NEJM study in the following post.
Mata, I’ve explained some of this before. I’ll have to go into more detail, so that you can really understand it. I can’t do this without appearing to be promoting my own business/services. In my 14 years of internet debate, on Usenet and on blogs, I have assiduously avoided self-promotion. I hope that you’ll agree that this is the standard I’ve maintained on Flopping Aces. I haven’t exactly endeared myself to you guys, in the pursuit of your “business” — I hope that you’ll agree.
But here goes, only because you (and Aye and Mike) keep making such a “gotcha” point of this.
My background is that I trained in oncology at the National Cancer Institute, in Bethesda. During this time, I began what has become my lifelong research interest — receiving biopsy specimens of fresh, living human cancer and culturing the cancer cells and tissue in the laboratory and testing these specimens to determine if they are “sensitive” or “resistant” to the various drugs which could be used to treat this disease. I have several websites and blog devoted to this. The most convenient overview is my medpedia bio page: http://www.medpedia.com/users/110
This describes my background and gives links to my various websites, lists relevant publications, recent presentations at national and international cancer meetings, etc.
For the first 8 years after completing my training at the NCI, I continued this work as my academic research in my position as an Associate Professor at the U of California Irvine. I then left this full time position to found a venture capital backed company (Oncotech, since acquired by Exiqon), to provide services (based on my technologies) in the private sector. Later on, I recruited a successor and left the above company to start my own small business. I did this for a variety of good reasons, among them being that I wanted 100% ownership and what might be called “artistic control” over the direction taken. I basically cashed in my IRAs, took out 2nd and 3rd mortgages, cashed in kids’ college funds, etc. to start this business (which is described at http://weisenthalcancer.com).
We obtained Medicare approval and coverage in the year 2000. To this date, Blue Cross does not provide coverage, except in cases where they are sued by their subscribers, who have won 16 of 16 cases decided in Small Claims court (which pays claims up to $5,000 per claim, here in California). The history and controversies related to the area in which I work is described on another website: http://weisenthal.org
Between 2000 and July 2008, we participated in Medicare. However, oncology changed dramatically during this time. The “old” drugs were mainly non-specific “poisons.” Tests for these drugs were comparatively simple, straight forward. We were able to cover expenses and make a profit. But, over the years, new drugs were introduced; testing became more extensive and complex. We innovated and developed new tests for the new classes of drugs. We are the only laboratory which provides testing services for these newer drugs. At a certain point, we found ourselves doing more than double the work we’d been doing in the year 2000 and, on average, more than 4 times the work of Oncotech and the other labs which provide this service. We could no longer afford to provide our services for the reimbursement level provided by Medicare (but note that Blue Cross and a number of other private insurers provided no reimbursement whatsoever, meaning that they were “rationing” the care of their subscribers, refusing to pay for tests deemed necessary by the patients and their doctors). So I did what every physician or provider facility can do, if he/it finds it is losing money on Medicare — I opted out.
Now, the situation is this: If a cancer patient and cancer doctor want to obtain pre-treatment cell culture testing and the patient has Blue Cross or Aetnea or some other private insurance plans, the patient has to pay the full costs of this testing out of pocket. For a Medicare beneficiary, there are two choices: the patient can either elect to have a basic level of testing performed by one on the Medicare participant laboratories, with Medicare picking up the entire bill, less 20% co-payments (which will be paid by private Medicare supplementary insurance, which most Medicare patients elect to carry). Or else the patient can elect to obtain a higher, “concierge” level of service, for which they must pay out of pocket (or which is paid in full by certain “Cadillac”- (I’m dating myself; today we should probably say “Lexus”) level private insurance plans.
But do you see how brilliant this system is, compared to the purely private sector? Everyone in Medicare can receive at least a basic service, with Medicare (and Medicare supplemental insurance) paying. Every laboratory which can make a profit on Medicare payment can remain within Medicare. Patients who want premium service can pay for it themselves (or with premium insurance). Laboratories who want to offer premium service can opt out of Medicare. Meanwhile, patients with Blue Cross or Aetna, etc. are just stuck with the whole bill for even basic service, or else they have to go to court to get the companies to live up to the terms of their contracts.
With regard to the issue of employee health insurance: I have only a total of 10 employees, including myself. The majority of these are part time. I currently provide health care coverage for only a single employee; health care for this single employee costs us $13,000 per year. We’d be one of the 90% of businesses exempt, under the House plan, to my knowledge, but, of course, we’ll have to comply with whatever law gets passed. As a small business owner in the private sector, I reserve the right to run it as I darn well please, within the confines of all local, state, and federal statutes and regulations. And my employees have the obvious freedom to determine whether or not the combination of wages and working conditions we provide makes sense for them, as well.
- Larry Weisenthal/Huntington Beach, CA
@mata (#82).
In a recent reply to me you said “give a girl some credit.” This was a nice, folksy way of putting it; it made me smile. I want to give you some credit here, but you are making it difficult. You are looking at a study which was a purely random sampling, in which the sampling methods passed the statistical peer review of the most respected medical publication in the world, and you imply that it is not valid, because it is only “one-thousandths of a percent” (actually, I think you need to leave off the “of a percent”) of physicians. While Mike and others gleefully quote Rasmussen polls which are not peer reviewed by other statisticians, which use opaque/proprietary sampling methods, “weighting” the sample to reflect what Rasmussen considers to be “likely voters,” and which samples on the order of 1,000 respondents (not providing any information about how many voters they tried to sample or did sample to come up with their final respondent pool) to represent 170 million registered voters which (rough calculation) is about 6 X 10 to the minus 6, or 0.000006 or 6 millionths of registered voters. 3 thousandths of physicians (your calculations of physicians) versus 6 millionths (my calculations of registered voters) means that the NEJM poll of physicians was 500 times more robust than the Rasmussen polls of “likely” voters. And the NEJM study was statistically peer reviewed, with transparent methodology, as opposed to Rasmussen, which is neither.
Come on, Mata. This is a straw man and you know it. When did I ever once “demean” the public’s opinion as irrelevant, much less “continue to” do it? Answer this. I don’t do this sort of thing to you, and you shouldn’t do it to me.
You make other statements which are pure conjecture.
America’s doctors wouldn’t be supportive of health reform if they knew the details of the House bill. Well, that’s not what the poll was about. The poll asked doctors what type of plan they’d favor: private, public, or mixed. 63% said mixed. 27% (disproportionately surgeons) said private. 10% said public. That’s 73% in favor of some form of “public option.” 55% would be in favor of having Medicare-style “single payer” down to age 55 (down from 65, as it is today). They didn’t ask the question of what would you prefer, purely public or purely private, so your comment that they won’t be getting what they want is invalid on two accounts: firstly, there is no chance that the USA will go to a Canadian style single payer system ; all proposals on the table are robust mixtures of private and public or quasi-public. Yes, I agree that it’s likely that, over time, the “public option” will become dominant, as it is in France and the other countries which have the type of system I believe to be optimal: public plan providing basic coverage for everyone; those wanting more pay for more, as opposed to everyone having to obtain private insurance for even basic coverage. I provide a concrete example, pertaining to my own work, in #85. Secondly, the doctors weren’t given a choice of only two things: pure public vs pure private; so we don’t know how they’d have responded to a hypothetical about Obamacare morphing from mixed private/public to pure public (which isn’t going to happen, anyway, no matter what Barney Frank or even Obama may wish).
With regard to “my theory” on why Medicare is going broke; no, it’s not “bunk.” Health care costs have spiraled out of control not because of bureaucratic inefficiency and/or fraud, but because medical technology has exploded in ways which were simply unimaginable. When I went to med school, there were no CT scans, no MRIs, no PET-CTs. Ultrasound was just starting to be introduced; it was only used for brains (to detect “midline shift” after head trauma) and not for obstetrics. We didn’t have a third the cancer drugs we have today and the new drugs cost ten times a much as the old. We didn’t have coronary artery bypass surgery. We didn’t have fiberoptic endoscopy (for colonoscopy, gastroscopy, etc.) On and on and on and on. And we didn’t have an aging population of baby boomers. These are the reasons health care costs have exploded, and the explosion has been worse in the private sector than in the public sector. In California, Blue Cross changed from being non-profit to being for-profit. Since then, the services they cover have gone down and their premiums have exploded (for example, as a non-profit, they used to pay for our testing services; as a for profit, they stopped paying for this, in contradistinction to Medicare, which does pay).
You claim that people could save and invest as young people to pay for their medical care as retired people. Yeah, right, we saw how well that worked with 401Ks.
The ugly fact which ruins your beautiful theory is that US private sector health care is the most expensive in the world; private health insurance premiums have more than doubled since the inauguration of President George W Bush. Private insurance remains solvent by raising its premiums at will. Medicare hasn’t been able to do this.
There are only two ways to pay for health care, either private sector or public sector. Raise premiums/taxes or restrict payment for services. Medicare provides the bigger bang for the buck, but there will always be a role for private insurance to provide both supplements and for a premium level of care, for those who wish to purchase it.
The people who understand the health care system best are physicians. Their views, as revealed in the NEJM study, will give the moderates all the “cover” they need. This is simply a personal prediction, which may or may not prove to be correct.
- Larry Weisenthal/Huntington Beach, CA
@patvann (#79):
Incorrect. The doctors were listed in the AMA Master file. This is the most complete listing of American physicians available. It also includes the 65% of physicians who are not AMA members. For example, I am listed on this database, even though I’ve never been a member of the AMA.
They asked many questions relating to health care. Not simply three. Read the study
The respondent rate compares very favorably with that of any poll of a large population group (e.g. Rasmussen, Gallup, etc.) which you can find. See my reply in #82. And the methodology passed stringent statistical peer review.
28% were conservatives. 42% were moderates. 28% were liberals. These numbers are similar to data for the electorate as a whole, especially considering that people with post-baccalaureate degrees are, on the whole, significantly less conservative than the electorate as a whole.
As I noted before, it is entirely customary for physicians (and other professionals) to be compensated for their participation in surveys relevant to their professions. The level of compensation provided ($25) was nominal, at any rate.
The survey has quite a bit to do with “the topic at hand.” Discussed by me in prior comments. Although the issue of public versus private health insurance is certainly of importance to the average American, it is of intense importance to the average physician, and physicians understand the problems with the current health care system much better than do average Americans.
Santa Clara flyer: awesome
Global Warming: some other time
- Larry Weisenthal/Huntington Beach, CA
Larry, personally I wouldn’t mind you nabbing some “self-promotion” for your business. When I worked in the LA film industry (and music industry prior) for 17 years, I used to have a saying about the celebs and their attitudes. On more than one occasion I’d have to remind them.. “We aren’t curing cancer here. We’re making a mediocre movie”.
You, genuinely, are striving for treatment, prevention and elimination of cancer. Frankly, I think that’s the cat’s meow. My regard could not be higher. So do not misconstrue my comment about you opting out of Medicare. I thank you for your links and, when I have some time in my very busy work life (which is *not* curing cancer….) I intend to explore more. Tho I’ve already visited some of your stuff, and the medical technology may as well be another language for me.
So let me concentrate on this simple statement you made:
I don’t have a problem with you and your Medicare opt out. And I most certainly want you to make a profit so you can be (hopefully) a successful risk taker. I am a fan of what you do, and it wows me.
What I do have a problem with is you can justify yourself opting out for reasons of profit and advancement, but you don’t seem to realize others in your profession deservedly have that same attitude. The more they cut Medicare services, the more will opt out and it will be harder for my parents, you and I, to find care in a system we are mandated to use at the age of 65 (unless we want to give up our SS checks).
I understand that technological advances have driven up costs. I also understand that often that technology is overused in order for doctors to pay for their advanced equipment. I also understand that when a provider is undercut for his costs, he overcharges the privately insured to make up for the difference.
Therefore, it makes no sense to put even more people on a system designed to undercut the providers base cost. It does, however, make a great deal of sense to reign in what drives up their costs…. i.e. malpractice premiums, cost of advanced tech equipment, negotiation of both equipment and drugs without the middle man (as even you suggest as one segment of the cure).
The bill before us doesn’t do this. It just expands the number of people on a program that cannot be fiscally sustained.
Now… INRE “the poll”.
Allow me to answer that. You demeaned the public’s opinion as irrelevant with an attitude that now the doctors have spoken, the matter is close. Or, as you put it:
Now I know you don’t mean to sound pompous nor arrogant, but … forgive me… you do. This is much like Congress who ignores public opinion on bail outs, fiscal responsibility, and does what they want because they believe we, the public, aren’t smart enough to make a reasonable decision.
You may be a doctor with experience in the costs of business and delicate balancing act of too low of reimbursements. But I assure you, the public who has dealt with having to accept “some treatment” over the “best possible treatment”, and less doctors who are willing to treat them, also have experience. The medical professionals are not the end all, be all magi of how the system works. Therefore, just because 2130 plus 991 professionals would like to see a public and private mix (which we already have, with an unworkable in balance *mostly* do to the deficiency of payouts for the public option) doesn’t overrule the public opinions. People are mostly trying to “katie bar the door” for further erosion of current coverage, and prefer to find a way to cut the costs of doing unneccessary business. Again, none of which the proposed legislation does.
Last, about the poll itself. You must be confusing me with others when you say I laid out a straw man about the numbers. You are not addressing a “poll” fan. I’m on record here in multiple threads about how I put *no* stock in polls. Sampling 1000 to 3000 people out of a population of over 300 million, and prounouncing this the opinion of the nation, is simply ludicrous.
So this same attitute carries over to your 1-3 thousandths of medical practitioners.
Nor do I put stock in Rasmussen particularly… same reasoning. What I do look at is the cross section of those in protest (across party lines), and their increasing personal involvement with public protests, as a sign of the rising opposition. These voices should not be cast aside as uneducated and unimportant because doctors and PharMa have another opinion. Nor do I accept “the AMA support” since there are many dissenting doctors within that body. I was a union member for years, and I assure you… they took many positions I personally opposed.
I read the poll info you provided. And as I said, what struck me is that these doctors overwhelmingly did not want a single payer system, nor an effective comparative database. I’d say they, and the public, are in agreement.
So it again comes down to the base difference you and I have. You believe these are not steps to a single payer system by design because you want to believe that. I, however, believe this POTUS and his Congressional cronies who have stated, in no undercertain terms, that single payer is the quest. I do not possess your blind faith in promises when I can read the legislation that states otherwise. And blind faith will be the death of us… literally.
@mata: thanks for #88
I have only one follow up comment, which is just a clarification.
I don’t want a single payer system either. There is no bill under serious consideration which has a single payer system. But only 27% of the physicians wanted a purely private system, without a public component. As I stated previously, these were disproportionately surgeons, who benefit disproportionately from a private insurance care system which reimburses generously for procedures but which pays comparatively little for primary care medicine. Most Medicare reforms under discussion call for narrowing the gap between specialty and primary care reimbursement, which means that surgeons would be gored while other doctors would benefit. So it’s a bit of a civil war, fighting over shares of the pie. As I tried to illustrate with the prostate cancer example, surgery has a way of generating its own demand.
- Larry Weisenthal/Huntington Beach, CA
Larry, if you don’t want a single-payer system, then why do you support a bill that will inevitably shut them down????
I KNOW it does not have that specific language in it, so spare me…But it WILL eventually force them out due to the government’s ability to operate at a loss!!
Even the CBO agrees!!
Do you not see it????
@Patvann:
Now we are starting to make some progress.
What I favor is a system in which there is a baseline level of healthcare service for everyone, provided by private doctors in private hospitals, but paid for by the government, as in the case of Medicare. In addition to this, there would be private insurance to pay for premium levels of service, for those who want premium levels of service. Physicians and hospitals would be free to provide services within the public (“baseline”) system or in the private (“premium”) system, but not both. This is the way that Medicare works now. This is also basically the heart of the French system (except I think that French providers can participate in both public and private systems, which I personally don’t favor, but this particular point would be a matter for debate).
I agree with you and with the CBO that, with regard to providing the baseline service, the public system would eventually win the lion’s share of business, as it does in France. This leaves the private insurance companies to compete with each other in providing plans to pay for premium service levels, as they do all over Europe and Australia (though not in Canada, where the system is not friendly to this approach).
Therefore, everybody wins and nobody worried about rationing need get rationed, provided they are willing to pay for it (I agree with Mata that premium health care is not a “right,” anymore than personal bodyguards are a “right” in a system in which there is a public police force to provide for a baseline level of personal protection). And please remember that there is already a lot of rationing going on, and it is going on mainly in the private insurance system. I also think that these reforms would gradually move private insurance funding from employers to individuals, which would make the entire economy more efficient, by increasing job portability (which having the public plan paying for most baseline services would also do).
- Larry Weisenthal/Huntington Beach, CA
@openid.aol.com/runnswim said: ” nobody worried about rationing need get rationed, provided they are willing to pay for it “
Larry finally admits what many of us have said all along. The Dems health care plan will lead to rationing except for the rich. This will create a two tier system where everyone who is not rich will be treated to the horror of government care (or the lack of care, but with all the nastiness and indifferrence govt. is famous for).
Does that sound like change we can believe in?
What will all the ACORN types do when they see the rich get better care than the poor?
That is total baloney.
First, as I keep saying, there already IS rationing! And it’s much worse with Blue Cross, Aetna, United Healthcare, et al than it is with Medicare.
With Medicare (and with any public option to come), all coverage decisions are made with complete transparency. There are 5 levels of appeal, with the last being the congressperson. With the private companies, it is opaque and the appeal process is much less patient friendly.
Right now, we already have a two tier system in the private sector. This is why I thought it necessary to have
Blue Cross ($12 K per year) plus my AMA Catastrophic (another $12 K per year). The catastrophic was to take care of all the expenses that Blue Cross rationed me out of. Denials for state of the art treatment and drugs. Disallowance of care by providers “out of network,” as when I want to go to NYU for thoracic surgery or Loma Linda (near Palm Springs) for Proton Beam radiotherapy or to Florida for a DeBakey trained “beating heart” bypass surgeon or to Louisville for a recommended hepatobiliary surgeon or to St. Johns Santa Monica for a specific stomach cancer surgeon. This is what I mean by “premium” level health care, and if you think your own health care plan would give you the flexibility to do these things (as Medicare does and as the “public option” surely would), then I suggest you read the fine print in your insurance policy, which is perfectly good, until you really need it! Lifetime limits on coverage, etc.
At the time when I started purchasing both “basic” and “premium” insurance, Blue Cross was only about $6K and the AMA catastrophic $3K. Within 5 years, they’d increased from a combined total of $9K to $23K. And I still thought it was worth it, until the AMA started limiting coverage for oral cancer drugs to $15K per year (for drugs which can easily reach $100K per year). So I dropped the AMA and switched to an $8K deductible Blue Shield plan for nearly $12K per year which I consider to be inadequate. I’m exposed to risk of personal bankruptcy for certain highly foreseeable catastrophic illness. And I lack the complete flexibility to choose the provider and hospital of my choice, which I won’t again have until I’m eligible for Medicare.
This whole “rationing” business is part of a shameless campaign of scaremongering, from the same people who gave us “death panels.” It’s frankly disgusting.
- Larry Weisenthal/Huntington Beach, CA
@openid.aol.com/runnswim: Multiply every complaint you have about the current health care system TIMES TEN and you will understand the unintended consequences of a federal takeover of health care. THEN, factor in the negative impact on small business and the picture gets even worse.
Larry, you have used more words here to mask the disease that is the Dem plan than you even did with global warming. You think that by flooding the board with thousands of words, most of which are repeated over and over, that somehow your words will become fact? I don’t think so.
@Mike:
That’s absolute nonsense. I think that Medicare already is more than a third of total heathcare and total federal funded health care is about half.
Medicare works beautifully — much better than Blue Cross, Aetna, etc. for both patients and most doctors — and gradually expanding Medicare would be a relatively easy thing to do. That’s where health care reform is headed. This will increase patient choice, decrease provider red tape, and lower the overall cost of health care, which is why 72% of American doctors prefer a public component in health care reform.
- Larry Weisenthal/Huntington Beach, CA
Larry.
Gotcha. On every count and point you’ve spewed forth.
And if you pay that much for healthcare, you are either stupid, or a lier. Or both.
I pay my own Kaiser HMO for around $5G a year and it covers two adults and 3 kids, with a $1000/year deductible. The max payout is in the millions. (Payments went down by 300/yr after my eldest left the home for the Corps.)
It also paid for my wife’s stage3 3mmdeep Malignant melanoma biopsy/surgery/treatments for $240 out of pocket atop the premium/deductible.
And I KNOW you know what that treatment entails…and what the survival-rate is.
After twenty years of Obamacare would a 45 year-old woman who has a 5% chance of living 5 years be guaranteed a 1/4 million dollars of treatment? I think not.
Was my wife lucky, and possibly a fluke? I’ll say 50-50. All I know is that NO ONE second-guessed my doctor, and NO ONE in the government hinted at giving up.
Because I’ve done the research on you, and even went so far to ask my wife’s doctor about you, (She’s read your work, and is sending me the papers, so I’m not CHARGED FOR EDUCATING MYSELF ABOUT THE WORK OF A MEDICALLY GIFTED PERSON.)
I am willing to send you her entire history, and billing. Dr. Vampithy gave it to me on CD.
DON’T doubt me. Dual-Mastered Engineers who are former SeALs tend to do their prepwork.
And for G-ds sake stop the backtracking and obfuscation. It’s unbecoming.
@openid.aol.com/runnswim: That’s right Larry… Just keep repeating that B.S. over and over and over and hope no one notices you don’t have a leg to stand on.
It’s really getting rather tiresome. I don’t think you have made an original point in days.
P.S. Even Medicare admits they are in trouble:
http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2008.pdf
Larry.
I need to belay my offer, as the wife was not asked, and when I just did, she said: Not unless it’s done through Dr. Vampithy.
I was wrong to make such a personal offer, but you may be contacted in the near future by Kaiser California through professional channels via your practice. (Not UC Irvine)
I may disagree with you, but professionalism and integrity must remain paramount, not to mention patient confidentiality laws.
This public admission takes nothing away from all other statements.
@patvann. Kaiser is a very high quality health care organization, but you are limited to the (generally excellent) physicians and hospitals within the Kaiser network. For me, the most important thing in my health care plans is the ability to see who I want, where I want, and when I want. And to get whatever state of the art therapy which the responsible physician and I feel is indicated. You couldn’t have seen any of the physicians and surgeons across the country who provided the many services to my first degree relatives. Virtually anyone, anywhere with Medicare could have seen and been cared for by these truly world class doctors. I will say that Kaiser has been generally reasonable in paying for our services. It does require that a Kaiser oncologist initiates the order, provides a justification, and receives preauthorization, but, when these conditions are met, Kaiser has been decent about paying for it. Kaiser is way better than Wellpoint, Aetna, and US Healthcare.
P.S. Kaiser does have a $1 million cap on “out of network” lifetime benefits. As long as your health care needs can be met within network and they have the doctors and equipment you want (e.g. they don’t have a proton beam machine), then you are OK. But Medicare has no cap at all on any of its benefits and it has the nation’s largest “network” of providers, hospitals, and equipment.
With regard to Obamacare paying for expensive care for long odds cancer, you are speculating, but Medicare certainly does this, every day. The details and expenses paid by Medicare of/for my sister’s 6 year illness are every bit as impressive as your wife’s experience. I could say, well, Kaiser won’t be paying for this 20 years in the future with as much conviction as you can muster about Medicare or whatever “public option” emerges.
If you ever want to talk to me about a personal/professional matter, or just want to talk swimming, give me a call at 714-596-2100 and ask for Larry.
Mike’s continued personal attacks are duly noted. And I won’t tolerate being called a “lier” [sic] by anyone, no matter how good his butterfly stroke.
Of course Medicare is in financial trouble. Private insurance raises its premiums at will. Medicare can’t do this. But private insurance is having and producing huge problems of its own, which are not sustainable.
http://online.wsj.com/article/SB125306132331814219.html
(n.b. “reducing benefits” means “rationing”)
http://www.reuters.com/article/domesticNews/idUSTRE58E45420090915
- Larry Weisenthal/Huntington Beach, CA
@openid.aol.com/runnswim: Want to point out the comment where I called you a “lier” Larry?
Sorry if I don’t tolerate your repeating filibusters of failed talking points but you simply cannot be left unchallenged when you pull this routine. It’s not a personal attack in any way. It’s an OBSERVATION!
@Mike
)
Easy, big guy..I was the one who wrongly called him a liar. (lier…stupid spellchecker
@Larry
1. In my haste to read your post, I failed to note that you pay for more than your immediate family, and that you pay for extra coverage. I apologize for this, and will strive to be more careful next time (No scanning!), and keep my emotions in check, regardless.
Again, my bad.
2.Thank you very much for the offer of consultation. I know your time is your money, and the offer means a lot. In light of #1, it is a very gracious offer.
3. 59.03 sec 100m Fly in Dec of 78. Top that! (Oh g-d that was a long time ago!
Now back to the joust…
Do you think if Obamacare passes you will be able to keep that coverage (Congress calls it “Cadillac-care”) without being taxed to bejeezus for it?
According to my policy, Kaiser will cover equipment they don’t have (But I’m sure they will soon enough) at 80%. I also don’t ever see using up a mil out of network. 99.99% of the time, out of network usually means an emergency-room somewhere, where I have no choice in where the ambulance takes me.
Medicare is broke, Medicare can cross State lines, I have no problems with their service, I have a problem with it’s fiscal management, and the fact that private plans have a different set of rules. (Kaiser is also non-profit, but you probably know that.)
Look over the lists I’ve made in the other thread. I could fix this mess in one page. The REAL problem I have with this Bill is that it has NOTHING to do with “fixing” how healthcare gets paid for… I wonder how much you pay each year to keep the Tort-trolls away from your checkbook?
It’s all about power for the Democrats, period, and I stand by my previous posits.
@patvann: Holy s—; 59:03 LCM in ’78 (pre-bodysuit). I couldn’t carry your goggles.
@mike: whatever (is that sufficiently succinct?)
- Larry W/HB
I wonder what the AMA is getting out of the deal. Another closed door negotiation like Big Pharma got?
Transparency? B.S.
I stand strongly with PatVann:
Larry, when it comes to medicine, no question, you are the “gifted gold standard.” Why or how someone as brilliant as you are is not the least bit concerned about the ‘corrupt thugs ‘who will be overseeing “healthcare reform”, is a total enigma. This is far bigger than perscription drug or even Medicare; 1/6 of the entire economy to be exact.
Most of all, it is UNDOABLE; at least in our lifetimes. What are the chances that after half the country is either employed, compensated, or benefited other ways by “Obamcare”, anyone is going to vote anything other than democrat? They, in all of their corruption, will OWN us for the rest of our lives. Consequently, we will have to live with tax payer funded abortions, and life or death decisions, regulated by HHS, i.e, currently Kathleen Sebelius, who’s election btw was funded by “Tiller the Baby Killer.”
Do you ever stop and think about the people BEHIND the scenes, the real decision makers? Do you really believe, based on 9 months of Obama telling us one thing and doing another, that the people behind this can be trusted? I know you hate it when I agree with Palin on the “death panels”, but does it not bother you that the language she was referring to was written by a euthanasia supporting congressman from Oregon, only recently discovered? Does it not bother you that, unlike what they want us to believe, abortions WILL be paid for by tax payers?
And all of that is just for starters. The halllmark of this administration is the relegation of human life. You more than anyone on this blog understand the places biotech is going; when no man has gone, and with no regulations. Watch for the Dickey Wicker amendment to be overturned next ,after “health care passes of course”, and all bets are off on “human experimentation.” Before your first grandkid is born we will have “fetal farms” where ‘embryos’
are grown for ‘spare parts’. Not long ago, I referenced an article out of the ‘esteemed NEJM’, the medical journal you agree as being the cream of the crop. Here’s an excerpt:
Why would the NEJM run such an “opinion piece” if what I’m claiming is “scare mongering?”
Are you totally unaware how much of a ‘behind the scenes effort’ is being made to “reduce population?” Of course, it never makes MSM. Just follow “the big money” on population control.
Gosh, even “swine flu” creeps me out. Is it just me, or is there just a little too much “hype and certainty”that just may contribute to the death, or dare I say, sterilization, of many of us?
And how about the elderly? They more than anyone have paid all of their lives into Medicare, only to come into their sunset years and be given the Obamcare line that “A 25 year old has much more worth than you, consequently, your hip repleacment, or heart sugery, simply isn’t ‘economical’. I agree that currently, Medicare is a good thing. But to think it is going to “stay as is or improve” is a pipe dream; not under these thugs.
I could go on endlessly, pointing out why the “people in front and behind the curtain” are not to be trusted. PatVann is right. It is ALL ABOUT POWER. And what is more of a “power statment” than who controls human life, from conception (embryo), to ‘natural death’?
We don’t and never had a “population” problem. Resources are more plentiful than ever, and even if they weren’t, who are any of us to decide for our Creator. Our only problem is a morality problem, from which all others follow. Under the Obama adminsitration, “healthcare” will not only be the death of many of us, it will be the death of America .
Like most Americans, I’m totally for health care reform, but not at the expense of human life, which, ironically, is what “Obamacare” AND POWER, is all about,
@Aye (#103): Can you provide a link? There’s a lot in that which is just plain wrong, but I’d like to read and seriously consider it, before responding. – Larry W/HB
@pat:
Can you provide a link for the above quote?
- LW/HB
@openid.aol.com/runnswim:
The link is embedded in the bolded red first line of my comment.
Just click on it.
@aye: thanks.
It’s a questionnaire — not a scientific survey; how do I know this?
“Responses are still coming in.”
Some factual errors:
It wasn’t a “National Public Radio” poll. It was a scientific survey, with methodology passing stringent statistical peer review, conducted by the Mayo Clinic and the University of Chicago, and published in the New England Journal of Medicine.
The LA Times story was centrally about the Mayo/Chicago study (I provided a link to the full text of this study). As part of the story, it included related background information about the official position of organized medicine, through the AMA.
I think that the AMA membership is about 30% of America’s doctors. There is a lot of internal dispute: it’s chiefly a battle over the “pie.” Right now, procedures get reimbursed generously (i.e. surgeons, interventional radiologists, and the like), while primary care is reimbursed poorly. There is a nationwide shortage of primary care doctors and a surplus of surgical specialists. So health care reform (which includes Medicare reform) calls for “redistributing” (through changing reimbursement formulas) reimbursement from procedures to primary care medicine. Of course, this puts the primary care doctors on board and puts the surgeons on the other side. One can’t possibly evaluate the Investors Business Daily poll without detailed information as to percentage of respondents which were in each type of medical specialty and how these percentages stack up against national figures. These data were provided in detail in the Mayo Clinic/U of Chicago study, but not in the Investors Business Daily poll.
This is utterly ridiculous and has no credibility whatsoever.
This is utterly ridiculous and has no credibility whatsoever. You’ve got people who have invested a dozen or more years in post-high school education and they are going to bail because their incomes might possibly drop from $300K to $200K? And, as I noted above, the doctors who’s incomes might drop most are those who are in oversupply and the doctors who’s incomes are likely to rise are the doctors in the shortest supply.
>>Hope for a surge in new doctors may be misplaced. A recent study from the Association of American Medical Colleges found steadily declining enrollment in medical schools since 1980.<<
This makes it sound as if people are reluctant to go into medicine. Not true. This is because medical schools nationwide reduced enrollment by 20-33% in the early 80s because of fears of a "doctor glut." Med school admissions have never been more competitive than they are today.
http://www.aamc.org/data/facts/2008/2008school.htm
n.b. Compare "applications" (number of people applying) with "Matriculants" (number of applicants accepted and enrolled)
Here in California, a single "B" in organic chemistry is viewed as a death knell for successful admission by pre-meds.
I can't comment further until I can actually see the actual details of the poll methodology. But the article itself is obviously written with a strong point of view.
PDill's message is more about abortion and anti-Obama sentiment than about health care reform, per se. How do I respond to "Obama is evil?" I am supposed to say "No, he isn't?" So it wouldn't be a productive discussion.
- Larry Weisenthal/Huntington Beach, CA
@Aye: my reply to #103 went to spam. – LW
Larry, I wish you would focus more on the “overall big picture” of the types of people running the show, instead of trying to defend your POV by whitewashing soundbites and symantics.
For the life of me I can’t fathom how you don’t “get” these guys, especially considering your expertise in medicine and reputation for ethics and good character. PLEASE Larry, at least in this most critical crossroad of American politics, dare to go where l