Highlights from special Health Care issue of "Wingnut Monthly": Earlier in December, Oklahoma Senator Tom Coburn
gently warned senior citizens they would "die soon" if the Democratic Health Care bill passed. Then two nights ago Herr Doktor Coburn encouraged citizens to
pray for something to happen to Democrats so they would be unable to make the vote. And now ex-Guv Sarah Palin
re-invokes the specter of "death panels".
To put it charitably, I'm less than enthralled by the Health Bill-- simply increasing coverage
within the current flawed system doesn't do much for me. [And just to be clear, since I've been (embarrassingly) silent since inauguration, I'm less than enthralled by most of Obama's presidency, thus far, too. If we were playing by Bush-league rules, perhaps we could say that the first nine months of one's presidency hardly counts... but that's another post. I will tell my
PUMA friends, though, that the Dem caucus wouldn't have 60 senators right now if Obama hadn't been nominated, so enjoy the luxury of complaining about an underwhelming Health Care bill rather than re-"fighting" the Clenis wars into the 2010s without even the remote possibility of passing "Hillarycare".]
Anyway, this is worth reading: [libertarian] Matt Welch's very welcome and
personal perspective of American and French healthcare. He offers some questions that small guv peeps might do well to ask themselves.
Also,
Newsweek's Jacob Weisberg
reminds us of the Republicans' 2003 Medicare prescription-drug bill. Remember how that donut for Big Pharma was passed?
Bush officials threatened to fire Medicare's chief actuary if he shared honest cost estimates with Congress. House Republicans cut off C-Span and kept the roll call open for three hours to cajole the last few votes they needed for passage. Majority Leader Tom DeLay was admonished by the House ethics committee for threatening to vaporize the son of one Michigan Republican in an upcoming election.
The real significance of that episode, however, is not their bad manners but the policy Republicans produced the last time health care was on the menu. Their bill, which stands as the biggest expansion of government's role in health care since the passage of Medicare and Medicaid in 1965, created an entitlement for seniors to purchase low-cost drug coverage. Simply stated, the law is complicated as hell, costs a fortune, still isn't paid for, and doesn't do all that much—though it does include coverage for end-of-life counseling...
In their 2009 report to Congress, the Medicare trustees estimate that the 10-year cost of Medicare Part D is as high as $1.2 trillion. That figure—just for prescription-drug coverage that people over 65 still have to pay a lot of money for—dwarfs the $848 billion cost of the Senate bill.
...
And unlike the Democratic bills, which the Congressional Budget Office says won't add to the deficit, the bill George W. Bush signed was financed entirely through deficit spending.
Like they did with officials who made realistic cost estimates about the Iraq War, the Bush Administration also
pressured nonpartisan analysts to not disclose the true costs of its Medicare Drug bill. Bush pledged in his 2003 State of the Union address that he would hold the Drug bill cost to under $400 billion, but when reasonable analysts had higher estimates-- uh oh!-- the administration suppressed them with threats, and thereby prevented the public from debating the issue with even remotely honest numbers. [And teabaggers filled the streets to protest saying
we can't deficit finance such a monstrous entitlement while we wage 2 wars!-- oh, wait, no. That didn't happen.] So, basically,
the likely true cost of the Prescription Drug bill will be $800 billion more than Bush's forecast. At the time the bill passed, conservatives expressed their keen disappointment with a disgruntled clearing of the throat. But Obamajokerhitler's $875 billion bill is "socialism".
I see.
Labels: Cons, GOP, health, Obama
14 Comments:
Why do you persist in using the pejorative term "teabaggers" for the citizens who attended the tea party meetings? And call global warming skeptics "denialbaggers"?
These silly slurs add no weight to your arguments.
MAD- Maybe it's because the Teabaggers were ig'nant enough to give tTHEMSELVES that monicker. Ig'nant I tell you.
Ricky Ricardo,
When someone attempts being "cute" on a comments section of a blog by calling someone else "ig'nant", they might want to mix in spellcheck.
Y'know, so theyd ont com4 of l0kng l1k4 th4y sfkpell 0n @ 4f grade lvel.
oyster: Gotta take time to read through your link...
MAD: I make fun of the tea partiers with the use of the term "Tea bagger" because I find it amusing, and I find their outrage incredibly selective. And yes, as Ricardo mentioned, some of the undiscpiplined TEA partiers don't help their cause when they use tea bags as symbols and the term "teabagger" to refer to themselves.
I make fun of Global Warning Denialists, as well. "Denialbaggers", however... is not as funny, and probably won't catch on. Hit and miss....
But, as you well know MAD, despite our lofty stoa on the sidebar, we're not above being sarcastic, scathing, and prone to name-calling here at YRHT.
As for true, sincere global warming skeptics who know something about science... I have no problem with them, and wouldn't treat their arguments with silly ad hominems. Same goes for the many sincere skeptics about other issues.
GO: "oyster: Gotta take time to read through your link..." Please feel free to do this on a regular basis.
I read through it, & I started laughing immediately...
He says that here, we wait "5 days" & then says that they wait "a day or three"...
C'mon, man...Seriously?
Also...I've actually discussed the French Healthcare system & its positives on your site prior to today. Their version of EMS/Ambulance/First Responder services are first-rate, & should be a model for what the US would want to become.
You see, they don't use lightly trained EMT's. They use actual doctors with a bevy of equipment & knowledge to actually treat & stabilize a patient. They then move them to a hospital based on that hospital's speciality.
IE-its ability to actually treat the issue at hand the patient presents.
Having said all of that, just like the CBS Sunday Morning piece I saw on French Healthcare that detailed all the positives...There are negatives...
Like, perhaps...The fact that they're facing MASSIVE cuts/changes lest a 10 billion dollar deficit they ran last year turn into a 21 billion dollar deficit this year.
Read more about it at this extremely right wing source: The BBC
Also, according to British figures, France has the lowest # of doctor's per population than the UK, Italy, Germany, & Japan.
Also...When it comes to perscriptions...Do you realize why pharma products are so cheap in the rest of the world? Do you realize why AIDS medication in Africa costs about $100/year, thanks to Clinton's diligent (and extremely altruistic & laudible efforts internationally) work?
It's because pharma companies get to RAPE the United States initially in order to make their money back on the vast sums they spend on R&D to get these products to market.
If pharma companies forced other nations worldwide to eat the early costs of pharmaceuticals when they hit the market, you'd see foreign healthcare programs skyrocket.
That's sort've an ancillary issue, but one that's informative in terms of how foreign healthcare system's are able to produce more affordable care in opposition to the American Model.
Quite simply put, on this subject, if it weren't for America being so expensive, they wouldn't have cheap drugs to buy.
Without the profit motive, pharma companies will halt R&D programs & reign them in, spending dollars only on products they know will yield high profit margins.
Which means less innovation in healthcare worldwide.
Crow about France all you like, but they're already running a deficit, & they already have a dwindling healthcare workforce in terms of actual doctors.
Did I mention the CBS piece I saw talked about most doctor's making $50-60K/year?
Do you think any physician will want to go into the field of medicine-and incur the STAGGERING debt med school requires-for a job paying no more than a sub-standard mortgage loan officer?
Get real, oyster...
Doesn't the French government subsidize the costs of medical school?
oyster,
Conservatives were irritated that a drug benefit under Medicare was likely inevitable, and that Bush's horrible bill was better that the alternatives proposed by the Democrats. It was still widely condemned on the right, but it wasn't a matter of "if only the other party was in power, we'd have fiscal responsibility." The Democrats were proposing a benefit that would likely be more expensive, not less.
This is why the "teabaggers" didn't take to the streets.
GO,
Did I mention the CBS piece I saw talked about most doctor's making $50-60K/year?
This is what most people don't understand. What other countries have is essentially super-Medicare. Doctors get a "take-it-or-leave-it" deal from the government, and unlike in the US, that's pretty much all they get. The result is that they get paid far, far less than they're worth.
As a result, many countries with universal care tend to poach doctors from developing countries:
Canada
http://www2.macleans.ca/2009/08/19/africa-says-canada-is-stealing-mds/
Australia
http://www.theage.com.au/opinion/we-must-stop-stealing-doctors-from-the-poor-20080710-3d4p.html
UK
http://www.dailymail.co.uk/news/article-483239/Zimbabwes-nurses-exodus-Britain.html
However, the US does it as well. Our medical school enrollments have remained static. Part of the reason is our excessively difficult system for training doctors whereby they have to endure several years of school, running up hundreds of thousands in debts, and then get paid nothing for working abusively long hours as an intern. The light at the end of the tunnel (high salaries) doesn't come until they're well into their thirties. It's easier to import doctors for lower paid jobs (i.e., as internists) who graduate from foreign medical schools and aren't forced through the fraternity initiation that is our system.
Still, the problem with out system can be easily solved over time by loosening up a bit on doctors. The problem with the European model is that they simply aren't willing to pay doctors all that well -- ever. They can't really fix that in the context of single payer.
As I recall, the tea bags symbols and use of "teabaggers" by the protestors ended when the left make a scatological linkage with the term, which the left thought was downright hilarious. Oyster, if continued use of the term provide you with some amusement, then have at it.
Anonymous: You can make $50-60K/year working for the State Of Louisiana, with no post-secondary degree.
I will again ask...Why would anyone go into the field of medicine & undergo the required training?
You will get lesser applicants. The best & the brightest will flock to industry & trades where lucrative livings can be earned.
Which will NOT include medicine.
Maybe the ugly truth that isn't being stated, as these statements about what doctors should earn would seem to be bearing out, is that demand for health care services in the U.S. is simply inelastic, i.e. not responsive at all to market forces.
If it were the car market, some people would have to have a Lexus (and also can afford it) while others make the reasonable decision that they don't need a Lexus (and maybe, probably can't afford it) and can get by with a Hyundai and opt for that.
With health care, it seems that no one in this country is willing to concede that they'll just have to make do with that Hyundai -- while in Europe they have less of a problem with that -- and that's, I suspect, why the cost problem in the U.S. in contrast to the European countries has become so intractable.
In this respect the French concept is commendable. Let people have the "Super Medicare" for the Hyundai level of care and if they feel like they need more than that than that should be on them as individuals.
The U.S. as a whole, it would seem, is probably going to have endure some shocks with a population aging as it is.
It will take good and wise leadership to soften the blows which would seem to be coming one way or the other.
Anonymous,
Maybe. But in order to achieve universal care, that means we have to sacrifice some things:
1) Worse overall quality. With cancer care, you can't tolerate Hyundai care. It will take your chances of living from "a really good chance of survival" to "probably worm food." This might be ok for the sniffles, but it matters for everything else.
2) Poorer doctors. It's no small thing turn a wealthy profession into a profession of modest means. You're making a whole profession suffer.
3) Less medical innovation. If you try to give everyone Hyundai care and control costs, medical research will also suffer considerably. It won't stop, but it will slow. Don't count on that new treatment to come along in time to save you.
4) Bad for developing nations. The cheapest doctors still come from overseas. Cost-conscious Western systems poach from the third world.
5) Still a budget buster. Even providing Hyundai level care is going to be difficult in the future if you want to guarantee universal coverage. Costs are continuing to rise.
I think perhaps your "Hyundai" analogy is a bit dated. What car analogy would you compare the current U.S. system to?
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