The chattering classes in the US want to have it both ways over the president’s health care victory. It is to be at once “the most sweeping reform since the Great Society” era of the 1960s and nothing to get all het up about. You racist.
That 53% of the population inclined to wonder whether 1/6 of the market economy ought to have come under direct federal control for the first time ever ought not peek behind the curtain at the parliamentary procedures used to shove it across the finish line. You really don’t want to watch sausage get made, if at some future point you might want to eat sausage.
And anyway, it’s none of your business.
The president was fond of saying that “doing nothing” about the 60-year old health care crisis was not an option, that cost growth was unsustainable. And while conceding that some in the health insurance business industry acted unconscionably when terminating benefits for those with emergent medical conditions, the vast majority of insurance malfeasance went the other way: People declined to purchase insurance until they had a palpable need. There isn’t an insurance business worth of the name that can make money offering coverage to people whose houses are already on fire.
And between “doing nothing” and “doing the right thing” there is often a world of difference. Not all motion is progress. Look overseas to Britain, where editors of the Economist know a thing or two about government health care takeovers, to learn about “cost control”:
The short answer is that the reforms will expand coverage dramatically, but at a heavy cost to the taxpayer. They will also do far too little to rein in the underlying drivers of America’s roaring health inflation. Analysis by RAND, an independent think-tank, suggests that the reforms will actually increase America’s overall health spending—public plus private—by about 2% by 2020, in comparison with a scenario of no reform (see chart). And that rate of spending was already unsustainable at a time when the baby-boomers are starting to retire in large numbers…
The Congressional Budget Office (CBO), a non-partisan agency, estimates that the new health reforms will cost the federal government some $940 billion over the next decade. Of that, roughly $400 billion will be spent by 2020 on the subsidies and about $500 billion on increased spending on Medicaid.
But that underestimates the full cost of this new reform. Elizabeth McGlynn of RAND points out that the huge numbers of newly insured—who now typically skip medical care or simply turn up, in a crisis, in emergency rooms—will soon consume a lot of routine medical services. She thinks this spending will expand the country’s health outlays even more than the direct cost to the federal exchequer.
And wasn’t that the point?
(This) points to the only certain thing about Obamacare: that this is just another episode in the long saga of health reform. Indeed, by adding tens of millions of people to an unreformed and unsustainably expensive health system, this reform makes it all the more urgent to tackle the question of cost.
On that, at least, left and right seem to agree. Paul Krugman, an economics professor at Princeton and a liberal booster of reform, wrote on the eve of the votes: “There is, as always, a tunnel at the end of the tunnel: we’ll spend years if not decades fixing this thing.” Robert Moffit of the Heritage Foundation, a conservative think-tank opposed to the effort, agrees, albeit in darker terms: “This marks the beginning of the next phase of this hundred years war.”
Nancy Pelosi was forced to admit time and again to her left wing that there weren’t the votes in Congress to pursue the liberal vision of “single-payer” health care, wherein the government taxes the people to provide blanket medical insurance via the existing health care infrastructure, earning the right to form a monopsony over the medical system. Once in that position, government would dictate to the medical system the approved schedule of treatments and prices. Expensive procedures will be rationed by availability. Innovation will be stifled. Wise Bureaucrats will be empaneled to pick at the extraordinary costs pertaining to end-of-life care. Choices will have to be made, and they will be – like this legislation – too important to leave in the hands of the people.
When Obamacare fails – as it will – to constrain costs, hands will be thrown into the air over the whole matter of private choices for personal services. It simply can’t be done, they’ll say. We tried.
The next tunnel at the end of Paul Krugman’s tunnel is single-payer health care. When it comes, it will fundamentally restructure the relationship of the American citizen to his government.
It may take a while to get there.
Sometimes you settle for half a loaf.
Settle my patootie!
We need to go after the thieves who stole the other half of the loaf and take it back from them. By whatever means necessary.
If not, then we need to jealously and tenaciously safeguard whatever crumbs we have left and deny the thieves access to them. Starve the beast.
There are 219 names of people to be thrown out of office in November. Maybe your “critter” is not on the list, or is invincible, but every one of us can help by targeting the other miscreants with money and editorial comments in their local district media and contacting friends in their districts to help chase them from office post haste.
Sitting back and awaiting further “compromises” to barter away what little remains of liberty and capitalism is not an option for patriots.
I will need to have my left hip replaced in the next few years; same condition that prompted the total replacement of the right last year.
While the physical condition is the same, it’s possible that the insurance situation won’t be by the time the left will need the surgery. All of which makes me wonder if I should talk to my surgeon about getting the left done sooner…rather than trying other treatments to put off the inevitable.
I’ve read enough horror stories from the U.K. and Australia about hip replacements – I really don’t want to be a pioneer when it comes to waiting lists in the U.S.
Kris, I would do it soonest. You know it’s coming and buying time, in this case, would foolish.
The UK needs to cut 20 billion pounds from UHC next year.
*No* elective surgeries will be authorized, and patients will only be seen after they have first contacted a doctor by e-mail and described their symptoms — even if those symptoms include arterial bleeding, judging by the report.
And *that’s* the model for HellCare, folks.
*That’s* the marvelous system the Lefties have shoved up our — ummmmmm — down our throats.
Now, where’s that black flag gotten off to this time…
(UHC = NHS)
%$#@! acronyms…
QM – believe me, I’m considering it. My next evaluation with my surgeon is September…I may bring it up at that time.
The backlash from the left regarding Caterpillar, AT&T, Verizon and John Deere’s announcements has already begun. Henry Waxman is demanding that the CEO’s appear before a Congressional Committee to explain their findings that the new socialist health care bill will cost them so much money.
http://www.powerlineblog.com/archives/2010/03/025940.php
Apparently these American Capitalists didn’t get the memo from Comrade Waxman to sit down and shut up and turn over their cash quietly.
The national level Democrats are just confused as to why someone would give an honest accounting of their finances, even if it is illegal to do otherwise. If something like that became a habit, it could make their tax evasion and progressive financial disclosures look bad.
To which I would respond: “Siss on you pister. Since when do we give an accounting of ourselves to you? I’m Chairman. Not you. B!tch!”
Ack-shully, corporations are *required* to provide an honest accounting of how they forecast earnings and expenses due to any unscheduled material event, or a company change. It’s called Form 8-K and it’s filed with the SEC *any* time either of those events occurs.
All those companies he castigated had previously *filed* Form 8-K with the SEC, enumerating precisely how HellCare would affect their operations and earnings.
Once again, Waxman has proved himself a blustering, clueless foolhard…
I read on someone’s blog yesterday that Bureaucrats/Administrators in Britain’s NHS have increased in number at a rate 16 times the number of RNs–despite there being a vast, critical shortage of Nurses. Why am I not surprised?
See,the above is, as my wife the RN and Director of Nursing at several institutions, could tell you because she’s seen the trends here, a classic bureaucratic response to problems of poor patient care. Expand the reporting requirements to document poor care caused by nurse and physician shortages and add bureaucrats to do the reporting–rather than hire add. Drs & Nurses in the first place to cure the shortage itself.
Typical.
Yep! So typical. You see it in the schools as well. When i drive by the Board of Education’s office in Waynesville, the very large parking lot is full. There are generally fewer cars in front of K-mart on a Saturday. FedGov is great at taking reports, but not so good in generating the atmosphere where servies are improved.
I can’t remember which of the Beatles said it, and it is so true, “everything Government touches turns to crap.”
“everything Government touches turns to crap.”
I would have said John Lennon, but it was Ringo Starr.
Well, Ringo always had the most sense of the Beatles.
Board of Education, heh. The one we have here had bullet-resistant facings put in front of the counters behind which they face the public in official meetings, years ago. Seems like the effects of guilty consciences to me.
Kris, dear … I’m with Quartermaster in his advice to get the other hip replacement soonest, while there are still excellent surgeons and efficient post-op care available. Frankly, we’re on an accelerating downhill skid toward the horrors of healthcare as it is now practiced in Britain, and we’ve seen news stories about filthy hospitals, nursing shortages and a whole raft of other shocking things in the Brit newspapers.
When I had my yearly physical last September, I had a long talk with our internist, and he pointed out some unpleasant facts; 1] that fewer and fewer medical students were willing to take on jobs like internist, and general practitioner, because the docs needed so much general knowledge and skills as well as specific information. 2]The students graduating now are heading straight to the higher-priced specialties — reconstructive and plastic surgery, heart surgery, neurosurgery and the like. They want to earn the big bucks right away, and I don’t blame them. As far as the experienced internists and other specialists are concerned, they can see the train-wreck coming down the track, that they will receive less and less compensation for their experience and skills, and a lot of them will retire and hit the golf courses and let the medical system crumble. Here again, I don’t blame them.
Anyway, it looks like you’ll get the best treatment if you do it right away, rather than wait.
Marianne
I’ve got Lumbar spine problems and I’m going to take a look at surgery myself in the near future. I’ve bought over 10 years for myself, but the wisdom of buying time has now ended. For myself, it’s now foolish an the more complex the surgery, the more important it is to get it done soonest.
Marianne – thank you (I think) for the stats. Nothing surprising there unfortunately.
My ortho surgeon is in his late 40s/early 50s (hard to tell). Now that I know I need the left one done at some point, I intend to be sure it is done by him. We will be chatting about it in September this year…with my personal view being to get it done before 2014, perhaps even by 2012.
I had hoped to wait longer. I am already guaranteed at least one revision surgery on the right hip; I was hoping to get the left hip “one and done”.
I can thank Obama and his minions for the fact that it’s unlikely that will happen now.
What the heck – I have the financial equivalent of a 7 series BMW on the right…why not a matched set?
QM – agreed. Soonest wherever possible. Good luck!
As a plus to the Dems longterm goals, this half of loaf does charge a premium for being married rather than cohabiting. Gotta breakdown the family before you can get total devotion to the state. Or was this just the Dems way of making the gay marriage issue go away?
Add to that that a modest say $5000 increase in salary would spark a loss of subsidy which would mean the salary increase would result in a net loss in funds available for non-state mandated use. So say good by to working/saving your way to a better life.
They’re going to share the wealth alright, but first they’ll make sure there is very little wealth left.
In his letter to Rep. Waxman, et al. last August, the CBO director Elmendorf writes, “Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending
overall.”
Knowing this, if said Congress decides, “We need to control costs”, what better ways than these?:
1. Limit preventive care by encouraging people to buy last-minute insurance.
2. Drive out private initiative by forcing all care to fit standardized “effectiveness” guidelines. *(NIH = “Not Invented Here”)
3. Drive out caregivers by lowering morale, leading to roughly 60% of physicians thinking of quitting. “After low reimbursement, the other causes of diminishing morale included loss of autonomy, bureaucratic red tape, patient overload, loss of respect, and the medical malpractice environment.”
4. Put a kinder face on End-of-Life-Phobia by enlightening the sheeple, “Most people can actually be taught to turn an outright crisis into an occasion for growth.”
5. Do this all in a way that private insurers cannot sustain, thus never having to pass an outright public option – love means never having to say you’re sorry.
I meant to add that Lex’s title is spot-on; health care in the US has now been engineered to fail.
“Most people can actually be taught to turn an outright crisis into an occasion for growth.”
We already *have* a growth.
It’s called “Congressional Democrats,” and it’s malignant.
More and more of the primary care will be handled by Physicians Assistants. I’ve been using a PA for nearly 4 years now and can say I’m satisfied. The problem, however, if there are few primary Physicians there will be no one to supervise the PAs.
Medical care is going to go to hell quickly in this country. People with any money will find themselves as medical tourists to places like El Salvador, Singapore, or the Philippines. The rest will be stuck.
I can echo what one of the founder said, and I paraphrase, I hope you enjoy your chains.
I imagine that when medical care really does fail to function, people will turn to any and every means to seek care outside the official system, same as has happened in other countries. This summer I hope to spend a bit of time in Mexico, providing medical care as part of a gospel outreach program, in an underserved, predominantly Indian population. On one hand, I quit official practice, have inactivated my physician’s license, no longer pay dues, and am not “current” on continuing medical education requirements.
On the other hand, the receiving population doesn’t care if I am officially approved. They are needy and grateful enough that even the most basic but timely care far outweighs the ostensibly available but cost-prohibitive care of their “official” system. And I no longer fear the “99%” that give Mike M. and Advokaat a bad name.
I’ve been known to make house calls. And to do kitchen-table surgery if a local anesthetic is sufficient. When times get really tough, it is possible to gain many of the benefits of medicine by knowledge and prudent testing. In many foreign countries, patients simply ask their docs what meds to take. No prescriptions are needed, the pharmacies handle patient requests directly. And so it may become in the soon-to-be-barter-economy. For when the feds just don’t help anymore.
Well Bill,
With the availability of Cocaine in this country, coupled with easy access to syringes and bottled water, making up a solution for local anesthetic use shouldn’t be all that difficult
Ah, now I see what yer icon means. Justrite scalpel blade, I wondered what it meant until now.
It will all turn to crap within a decade when a frantic and desparate Congress is forced to confront the fact our Credit Card has reached its limit,
http://tomet.net/Blog/2010/03/28/a-call-to-leave-the-armchairs/
“There is, as always, a tunnel at the end of the tunnel: we’ll spend years if not decades fixing this thing.”
Krugman is living on Cloud Nine — we don’t *have* decades to fix it, because in just *one* decade, just keeping HellCare afloat will require 90% of our GDP.
Krugman is a pair of brown shoes in a tuxedo world.
You’re a George Gobel and Johnny Carson fan I see…
2 comments:
1. VAT. No other way around it.
2. Private medical care for those that can afford. Just like a country club – you pay your dues, you get the “amenities”.