OT: I wonder what this means? (Socialized medicine news)

So that puts you in favor of regulation.

John

insurers"

On the merits, I've no opinion. The purpose, though, is to punish them, for daring to dissent.[1] It's the iron fist.

[1] They hired an accounting firm to add up the healthcare bill, and, foolishly got different numbers than the Democrats. Higher numbers. Much higher.

The Executive is punishing private citizens, telling us twice weekly who the new, real, Enemy of the People de jour is. Bush, of course, Wall Street, bankers, private-jetting car company executives, Fox News, CEOs, doctors, protesting citizens, then insurance companies...

Obama's solution to every problem is a lynching.

In my lifetime I've never seen the like of it.

-- Cheers, James Arthur

It's a new norm. Get used to it.

=== ...That brings us to Cap and Trade. Never in the history of humanity has a more idiotic plan been put forward and sold with bigger lies. Energy is the key stone to any and every economy, be it man power, animal power, wood or coal or nuclear. How else does one power industry that makes human life better (unless of course its making the bombs that end that human life, but that's a different topic). Never in history, with the exception of the Japanese self imposed isolation in the 1600s, did a government actively force its people away from economic activity and industry. Even the Soviets never created such idiocy. ... ===

"Pravda" was (and is) a fu$king communist newspaper, and it makes more sense than US newspapers.

&!@#*$!%^@#($!&@#%(^!@#*$&!*@#^%!(@#&$(!@&#%(!@&#$()!

--
Andrew

insurers"

You misunderstood their position. They don't oppose the original healthcare bill. They oppose the fact that the current version doesn't require everyone to get insurance, while allowing people to get insurance at a later time -- presumably when they're sick or worried about their health. The deal the insurers had struck with Congress, they thought, was that everyone would have to be insured, guaranteeing a HUGE windfall profit for the insurance industry. That's what they wanted all along.

And Price Waterhouse didn't get "different figures":

"Late Monday, the accounting firm issued a statement acknowledging it did not look at the entirety of the legislation, only the effects of four provisions that the insurance group wanted analyzed. "Though not retreating from its findings, PricewaterhouseCoopers underscored an overlooked caveat in its original report: 'If other provisions in health-care reform are successful in lowering costs over the long term, those improvements would offset some of the impacts we have estimated.'"

In other words, the insurance lobbying firm contracted with PWC to evaluate four specific provisions that they *knew* would increase prices -- IN ISOLATION FROM THE REST OF THE PROPOSED BILL. It wasn't PWC that was dishonest. It was our old friend the health insurance industry.

'Works for me. But it's not true that they've said that doctors or protesting citizens are enemies. Doctors need some shaping up, which most people would agree.

I think his solution is to call out the crooks and thieves who having been running wild and robbing us blind for a few decades.

You can say that again. We've never had a president with the guts to tell the truth about it. Now we'll see if we voters run the country, or if the Wall Street and health insurance industries run it. The latter two think they have a perfect right to run it any way they want. And they've got the best lobbyists, and Congressmen, that money can buy.

--
Ed Huntress

insurers"

I'm wondering if somebody has hacked archive.org.

Sunday, June 27, 2004

Kenyan-born Obama all set for US Senate

Kenyan-born US Senate hopeful, Barrack Obama, appeared set to take over the Illinois Senate seat after his main rival, Jack Ryan, dropped out of the race on Friday night amid a furor over lurid sex club allegations.

The allegations that horrified fellow Republicans and caused his once-promising candidacy to implode in four short days have given Obama a clear lead as Republicans struggled to fetch an alternative.

Ryan?s campaign began to crumble on Monday following the release of embarrassing records from his divorce. In the records, his ex-wife, Boston Public actress Jeri Ryan, said her former husband took her to kinky sex clubs in Paris, New York and New Orleans. "It?s clear to me that a vigorous debate on the issues most likely could not take place if I remain in the race," Ryan, 44, said in a statement. "What would take place, rather, is a brutal, scorched-earth campaign ? the kind of campaign that has turned off so many voters, the kind of politics I refuse to play."

Although Ryan disputed the allegations, saying he and his wife went to one ?avant-garde? club in Paris and left because they felt uncomfortable, lashed out at the media and said it was "truly outrageous" that the Chicago Tribune got a judge to unseal the records.

The Republican choice will become an instant underdog in the campaign for the seat of retiring Republican Senator Peter Fitzgerald, since Obama held a wide lead even before the scandal broke.

"I feel for him actually," Obama told a Chicago TV station. "What he?s gone through over the last three days I think is something you wouldn?t wish on anybody."

The Republican state committee must now choose a replacement for Ryan, who had won in the primaries against seven contenders. Its task is complicated by the fact that Obama holds a comfortable lead in the polls and is widely regarded as a rising Democratic star.

The chairwoman of the Illinois Republican Party, Judy Topinka, said at a news conference, after Ryan withdrew, that Republicans would probably take several weeks to settle on a new candidate.

"Obviously, this is a bad week for our party and our state," she said.

As recently as Thursday, spokesmen for the Ryan campaign still insisted that Ryan would remain in the race. Ryan had defended himself saying, "There?s no breaking of any laws. There?s no breaking of any marriage laws. There?s no breaking of the Ten Commandments anywhere."

On a sunny day (Wed, 21 Oct 2009 19:17:39 -0700) it happened John Larkin wrote in :

Price fixing is bad, it is not in the interest of the people. You need regulation to counter things like that. You need police, FBI, army, too. What is bad, is 'over regulation', when the regulators create regulators etc... So then you need regulators to control the regulators, OK forget it.... hehe

insurers"

I understood perfectly. All sorts of industries would rather strike some deal than be nationalized. They've seen the fate of the car companies, and the banks, and they're afraid.

I'd support any measure that was a) voluntary and b) done without any taxpayer money. Why voluntary? Because this is a free country, and you can't force people to buy things they don't want.

Then, if such a program really achieved what's being claimed--if it really were cheaper and better--people would buy it because it was cheaper and better.

Mr. Obama, on doctors:

A. They perform unnecessary tonsillectomies, because that pays more.

B. And amputate feet, for the money.

Notes: 1) Doctors refer patients for surgery. They don't perform it, and they don't collect the fee. 2) Medicare reimburses the surgeon between $700-1,000 for a leg amputation. That fee includes initial evaluation, the procedure, and

90 days' follow up.

To anyone who understands this stuff, the President looks foolish. I find him embarrassing.

The biggest insurer by far is the federal government. And they're the most expensive. In fact, their system is a complete disaster, financially. Good job.

If cost savings were the goal, there are any number of easy, effective ways to ensure that. But that's not the goal.

-- Cheers, James Arthur

insurers"

I still think you misunderstand, Steve. They don't care how they make their money as long as they make more of it. If they were put under strict regulations but made an extra 20%, they'd jump at it -- because their industry is an oligopoly, anyway, and competition in that industry is a joke to begin with.

I recognize your objections. Just don't attribute virtue to the health insurance industry or to their lobbyists, when there is none.

They're in a weird business. Like the car industry with their unions, they were co-conspirators with government and industry to create the multi-headed monster that they've become. Now they're in a corner -- an inevitable one, given the way they shaped the health care industry -- and they're looking for a money tree to shake while they preach "free markets" and "competition." They really don't care whose tree it is. They care about the value of their stock.

It's not that simple, and you know it.

He's right.

He's right again. This is something I've discussed with the endocrinology department at Beth Israel. It's a long story, and you wouldn't like it.

In this case it isn't the doctors themselves. It's the insurance industry avoiding treating chronic conditions and playing the numbers with amputations. It's cheaper for them to amputate. Thus, they won't pay for preventive care unless they're forced to. And that's because the average person changes insurers every 3-1/2 years. If the insurers pay for preventive care on their own, while their competitors aren't doing it, their competitor reaps most of the benefits.

My surgery was performed by an associate of the medical firm that referred me. Both doctors got the benefit because they work for the same company. That's common.

I was a medical writer and editor and the insurance industry was my audience. I understand it.

They're the least expensive by far, and they run with the lowest overhead in the insurance industry. Where are you getting this "information"?

Nobody has come up with a better one, but they've created a lot of noise about it.

--
Ed Huntress

insurers"

Thanks! Rich

Only antitrust laws, designed to protect Americans from theft by conspiracy.

Thanks, Rich

My point of view does not depend on business to be virtuous, just as we ought not depend on politicians to be virtuous.

That's enforced, in the one case, by free flow of information and fair competition, and the other, by checks and balances between the three branches of government--competition again, if you will.

Of course it is. Who wouldn't buy something that was better and cheaper?

No, he's an idiot. The pediatricians who recommend tonsillectomies are not the same doctors who perform them. If you want to be crass, the pediatrician's losing money by sending a constant-infection cash- cow away.

No, he's an idiot again. He defames doctors, saying they're rather amputate than treat because the one pays them "thirty, forty, even fifty thousand," and the other "a pittance." That is, frankly, a rather horrible thing to say.

And it's not true. Again, o The doctor who recommends the patient for surgery is NOT the surgeon. o The surgeon's fee is $700-$1,000, not $30-50k, and that fee includes evaluation, surgery, and three months' of follow up care. o The referring doctor does not get any of that fee. He loses, not gains. Surgery is already a last resort.

So, the President lets fly a horrible accusation, yet has absolutely no idea what he's talking about.

a) It's an absurd and disgusting premise that doctors don't try to save people's limbs--for any reason--or that insurance companies can somehow coerce doctors into doing that. b) It's complete idiocy and ignorance to suggest our current system does not already do its utmost to prevent amputations. c) So you'd lose a limb rather than pay some pittance for your own preventive care? How petty and foolish. The patient, ultimately, has to take care of himself. The doctor can't make you walk, lose weight, or eat the right things. It's in your interest, obviously, so you should do it, or make sure it gets done.

Ah, so you too accuse doctors of being despicable.

Their overhead is, like so many government programs, hidden from view: it's just contracted out.

As a simple sanity check consider this: if government were so wondrously efficient, we'd have universal care for the money they already spend. They currently spend about 7% of GDP for the ~25% of the population they cover; Canada manages to cover their entire population for ~10%, Great Britain for ~8%.

So, the taxes we already pay ought to have us 7/8ths of the way to universal care. If government were efficient.

Since they cover so few people, they're obviously horribly inefficient.

So, talk about horrible, money-grubbing insurance companies, the government is the biggest, and the worst of them all. By far.

If they want to reform the insurance industry so badly, they ought to start with themselves. They're the biggest, with the most power; surely they could do most anything they wanted to, and thereby control costs. But they don't.

Tort reform is an obvious way to save money. There are a bunch of other ways, but none are included in the Democratic proposals. So one has to conclude they aren't trying to save money.

-- Cheers, James Arthur

Fair enough. Then we might say that we can't assume that the "guiding hand" is always in place. Sometimes it's unscrewed and sitting in Captain Hook's velvet-lined box, and has been replaced with a chainsaw.

The health insurance industry is one of screwed-up incentives. All of the forces we expect to keep private business operating in our interest, as well as theirs, have been twisted and stood on their heads. David Brook's column on misplaced incentives in the industry, "Let's Get Fundamental," is an excellent summary:

Good luck. The insurance industry's biggest headache, which they work furiously to undermine, is the free flow of information. And you don't negotiate while you're lying on a gurney in an ER.

See above -- someone lying on a gurney, with a life-threatening condition that he couldn't possibly have anticipated, nor weighed when "choosing" his health insurance. (When was the last time anyone got to "choose," anyway? You take what you can get, unless you're well-off and paying full boat for individual insurance, to the tune of $15,000+ per year. I was lucky. I paid $12,500 for insurance and came out alive.)

You didn't listen carefully to the video link you pointed to. He didn't say the same physician was paid for the surgery. He said that insurers pay a pittance, at best, for preventive care. But an amputation costs *us* more. What he didn't say, and should have, is that it costs an individual insurance company less.

This is the point I was making about Beth Israel, which tried to run a diabetes prevention program but couldn't get it funded. But they collect tens of thousands performing amputations -- not just the amputations, but the associated health care after surgery that the hospital bills for (see the AMA's own statement about this -- they say the "tens of thousands" figure Obama used could be true with all costs considered). The doctors are furious about it, as they should be. And Obama's point in that video, which has been selectively clipped to give an unjustified impression, is exactly the same as that of the doctors at Beth Israel and elsewhere.

I think he did a poor job of making his points, and it could easily be seen as a slam on doctors themselves, while it's clear where his ideas on this come from. They've been part of the debate about private insurance for years. Properly stated, these issues are based on the prevention/surgery issue I mentioned in terms of costs to an individual insurer. He could have done a better job of explaining that.

But it's true that excessive tonsilectomies (and even the AMA says there were an excessive number of them done, until just a few years ago) and after-the-fact, preventable surgeries, are part of the screwed-up incentive system we have now.

Badly stated. But not incorrect. See above.

I wouldn't, but paying for one's own preventive care is not an option for the people Beth Israel had in their program for just over a year, until their charitable funding ran out.

I'll tell you after another year or two. So far, they certainly kept it in the family. It's even better than running your own radiology firm and sending your patients to it.

That's for the procedure and specific charges by the physician. But here's what the AMA says about it:

"Surgeons are not paid $30,000 to $50,000 to amputate a diabetic's foot. Medicare pays a surgeon, on average, from $541.72 to $708.71 for one of two procedures involving a foot amputation. It is possible that the total bill, hospital stay, rehabilitation, prosthesis, etc. may approach the larger amount mentioned."

Duh...and the hospital stay, rehab, etc. are run by the same hospital in which the operation is performed. Again, Obama was a little loose in implying that it's the doctors' own profit that's at stake. But it definitely is the health care industry's profit that's at stake. And because the insurer rarely benefits from their own preventive care payments, but winds up paying for the *lack* of such payments by other insurers, there's no payoff for them to pay for preventive care. Hospitals make out, and insurance companies make out. Doctors need to intervene in this charade. They're the ones who swore the oath.

I'm aware of the accusations about that. And I'm aware of the accounting that shows it's not correct, no matter how generous you are to the accusation.

There certainly are a lot of things about those two systems that we should consider. But your comparison is bogus. Medicare is for old people. Canada's system is for everyone, including lots of young people who are healthy.

Nonsense and bogus. See above

If all you cover is people over 65 years of age, and you're comparing that with coverage for everyone, Mother Theresa's clinic would look inefficient.

Not. See above.

For 65-plus patients, they do quite well.

It isn't the torts that cost so much. It's the overpriced insurance that doctors pay. "Insurer's Price Wars Contributed To Doctors Facing Soaring Costs; Lawsuits Alone Didn't Inflate Malpractice Premiums," WSJ, 6/24/02.

As Price Waterhouse said in their analysis of the four points the insurance industry sicced them on, there are savings in the program that they didn't even try to evaluate. But you have a point: much more has to be done to cut costs. The plan as it stands now is not enough.

Right now we have a bunch of misplaced incentives that are driving prices upward. David Brooks didn't cover them all in his article, but he got the gist of it. Having worked for Big Pharma and written to the insurance industry, I could go on about those things for a very long time -- which I won't.

But they have to be addressed. With our present system, they never will be. It's in the interest of the major players -- especially pharma and insurance -- for prices to keep going up. The insurers make FAR more from rising prices than they do from adding margins to their coverage. And that's the root of the problem.

--
Ed Huntress

So Ed, boil it down to my level for me. Can I just buy my employees a cell phone with "Buy Healthcare Insurance" on speed dial that they can just hit one button on the way to the hospital? And, that way I can cancel all our insurance. Will that work?

Maybe get one of those pendant thingys like "Life Alert"!

I get it. You want *other* people to be regulated.

John

hey!

How come you guys aren't cross posting to alt.kooks any more?

I know! It's a conspiracy to get through my filtering!

Mayo and Kaiser are better. Kaiser takes care of me and my employees for a fixed fee. Their doctors are salaried. They have a very strong incentive to be efficient and to keep me healthy, and my personal MD is pretty agressive about that. And she has no financial vs ethical conflict about doing what's best.

Kaiser is all automated. All my records are online to all my providers. After I leave my doctor's office, I walk 50 feet down the hall to the pharmacy, and they hand me a bag with my drugs in it.

Any sane US health-care reform should strongly encourage that model.

John

Well, I'm already regulated into poverty.

Aren't you always saying we need police to protect us from thieves?

Who protects us from the protectors?

Thanks, Rich

Any sufficiently large cartel is indistinguishable from government.

insurers"

Its starting.......

Gunner

"Upon Roosevelt's death in 1945, H. L. Mencken predicted in his diary that Roosevelt would be remembered as a great president, "maybe even alongside Washington and Lincoln," opining that Roosevelt "had every quality that morons esteem in their heroes.""