RKMBs Forums .::Important::. Politics and Current Events A right to Health Care

Bankrupt them. Bail them out. Then replace the hospital administrators and tell them how to run their businesses. It "worked" for GM and Chrysler...

It's always nice to see a friend's faith in another friend expressed. Basams really should be nicer to you.

You're a fucking retard.

broken.

David Scheiner, an internist based in the Chicago neighborhood of Hyde Park, has a diverse practice of lower-income adults from the nearby housing projects mixed with famous patients like U.S. Sen. Carol Mosely Braun, the late writer Studs Terkel and, most notably, President Barack Obama.

Scheiner, 71, was Obama's doctor from 1987 until he entered the White House; he vouched for the then-candidate's "excellent health" in a letter last year. He's still an enthusiastic Obama supporter, but he worries about whether the health care legislation currently making its way through Congress will actually do any good, particularly for doctors like himself who practice general medicine. "I'm not sure he really understands what we face in primary care," Scheiner says.

Scheiner takes a few other shots too. Looking at Obama's team of health advisors, Scheiner doesn't see anyone who's actually in the trenches. "I have a suspicion they pick people from the top echelon of medicine, people who write about it but haven't been struggling in it," he says.

Scheiner is critical of Obama's pick for Health and Human Services secretary--Kansas Gov. Kathleen Sebelius, who used to work as the chief lobbyist for her state's trial lawyers association.

"He doesn't see all the pain, it's so tragic out here," he says. "Obama's wonderful, but on this one I'm not sure if he's getting the right input."

What should the president be focused on? Scheiner thinks that a good health reform would be "Medicare for all," a single-payer system where the government would cover everyone and pay for it by cutting out waste in the system. "A neurosurgeon gets paid $20,000 for cutting into the neck of my patient. Have him get paid $1 million a year instead of $2 million or $3 million. He won't starve," Scheiner says.

Scheiner thinks that Obama's "public plan" reform doesn't go far enough. He supports the idea of that option for people who don't like or can't afford their HMO. But he worries that it will be watered down or not happen at all. "It's nonsense that the private insurance companies need to be protected," he says. "Why? Because they've done such a good job?"

He thinks that Americans have been scared into believing that they will lose the coverage they already have if a public plan is created. And he worries that nobody cares about the 50 million uninsured. "I have people who have lost their jobs and come to me and I give them drug samples," he says.

Scheiner says he thinks that Obama probably sees the virtues of a single-payer system but has decided it would be politically impossible to create one.

Reid Cherlin, an assistant White House press secretary who covers health issues, wrote in an e-mailed statement, "The President has been clear that while a single-payer system may work in some countries, it makes the most sense for us to build on what works in the system we have and to fix what's broken.

"He would certainly agree that there's too much waste in the system--where families, businesses and governments pay too much for too little," he added, "and that's why he's committed not just to expanding coverage but to reforming the health system to provide high-quality care at a lower cost to more Americans."

Scheiner says he never thought it was appropriate to talk about health policy with Obama, especially once he became a U.S. Senator. The one exception was medical malpractice reform. "I once briefly talked to him about malpractice, and he took the lawyers' position," he says.

Obama reiterated his opposition to caps on medical malpractice-related damages when he addressed an audience of doctors earlier this week at the American Medical Association's annual meeting. (See "Will Doctors Buy Obamacare?")

Scheiner, like most others in his profession, thinks that it should be harder to sue doctors and that awards should be capped. He says that he and other doctors must order too many tests and imaging studies just to avoid being sued.

Scheiner graduated from Princeton and then started at Columbia University's College of Physicians and Surgeons 50 years ago. After training in internal medicine in Chicago he joined a practice in Hyde Park. His partner was Quentin Young, a doctor known for supporting universal coverage and for briefly being the personal physician of Martin Luther King Jr.

Before selling his practice, he watched his income decline over the years to what he calculated to be $22 an hour ($2,100 every two weeks after withholding for taxes, health insurance and malpractice insurance.)

Scheiner thinks that any health reform should involve paying primary-care doctors better so they don't have to rush through appointments to make ends meet. He says that the medical students he encounters are no longer even taught how to do a patient history and physical exam. Patients get imaging studies and lab work instead of actual work-ups. "It's like in Star Trek where Bones had the thing he would wave up and down. They don't even talk to patients," he says.

Thats why you eliminate frivolous, not legitimate. The big problem is the damages say a doctor screws up and I miss $3000 woth of work, juries are awarding people $300,000 thats not exactly right.

Poll: Most Americans support government-backed health plans

The overwhelming majority of Americans support substantial changes to the country’s health care system, including a government-run health insurance option, a new opinion poll found.

The survey by The New York Times and CBS News also indicated most Americans would be willing to pay higher taxes so everyone could have health insurance.

Eighty-five percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt, according to the poll.

In addition, the survey found that 72 percent of those questioned supported a government-administered insurance plan — something like Medicare for those under 65 — that would compete for customers with private insurers.

Twenty percent said they were opposed.

When asked which party was more likely to improve health care, 18 percent of said the Republicans while 57 percent picked the Democrats. Even one of four Republicans said the Democrats would do better.

However, half of those who identified themselves as Republicans said they would support a public plan, along with nearly three-fourths of independents and almost nine in 10 Democrats, according to the poll.

President Barack Obama wants Congress to approve his health care reform proposals by the end of the year in order to fulfill one of his key campaign promises — providing health care to the 46 million Americans, some 15 percent of the population, who currently do not have any medical coverage.

Obama’s health care plan includes a government insurance option, which has been fiercely criticized by Republicans.

At the same time, the survey found that 77 percent of Americans were very or somewhat satisfied with the quality of their own health care, a factor that is being exploited by opponents of the president’s proposal.

The poll of 895 adults was conducted from June 12 to 16 and had a margin of sampling error of plus or minus three percentage points.

www.liberaltalkingpointswebsitethatnoonegivesashitabout.com

You copy and pasted something from a liberal website that we've proven wrong before.

I win again!

Wait till they do a poll with details.

President Obama, faced with declining poll numbers for himself and his agenda, must now relaunch his sputtering health care plan. So he held a press conference on Tuesday, and hosted a low-rated ABC News infomercial on Wednesday. In other words, he has his work cut out for him--especially since he is pursuing a health care agenda that flies in the teeth of what the American people really want. But Republicans should not be complacent, because if they are ever restored to agenda-setting power, it is likely that their policy platform will also run into a public-opinion buzzsaw.

The debate over health care has so consumed Washington wonks that few of them noticed the news from the Heartland over the weekend, news that demolished two central premises of the Obama health care plan: first, the idea that health care expenditures can be pushed down, and second, the idea that any sort of "fair" policy --"fair" as defined by the government is possible.

Inside the Beltway, health care combatants, right and left, were so busy wrangling over the minutiae of Medicaid rebates and insurance cooperatives, to say nothing of explosive controversies over "revenue enhancements," such as a Value Added Tax. And so these busy policy warriors barely looked up to see what happened on Saturday: the announcement that Steve Jobs, the grand guru of both Apple and Pixar, had undergone a liver transplant.

But after a few days, the impact of Jobs' self-financed and self-initiated medical plan became clear to liberal supporters of national health insurance. And so on Tuesday, The New York Times, that reliable champion of all liberal causes, ran a critical story under the headline, "A Transplant That Is Raising Many Questions." And while The Times stipulated that Jobs didn't do anything illegal, the newspaper sniffed, "It might not seem fair." Indeed. If Jobs can do his own thing, then what's to stop everybody from doing his or her own thing? And where would that leave grand plans for government supervision over life-and-death issues?

A lifelong resident of California, the 54-year-old Jobs temporarily relocated to Tennessee to receive his transplant. Observers estimate that Jobs spent hundreds of thousands of dollars for the actual transplant and associated treatment and chemotherapy, and perhaps millions more in donations to "expedite" the process. In the words of Jeremy Shane, a veteran observer of health care issues, "The father of the iPod and iTunes is now the poster child of iWantToLiveAtAnyPrice consumerism." And why shouldn't he? This is America, land of the free. Jobs is a billionaire, earning his money fair and square; why shouldn't he be able to spend millions on his own survival?

But the larger lesson for all of us is this: If people have the money, if they get the chance, they will spend more on health care, and happily so. And so the scientific sky is the limit for transplants, bionic body parts, you name it. In the words of Jim Woodhill, a St. Louis-based software entrepreneur active in the health care debate, "People want a war against serious diseases. And war is expensive."

Woodhill notes that health care is what economists call a "superior good." That is, a superior good is something people consume more of as their income rises, such as, say, caviar, Beverly Hills mansions, or better health care. (Potatoes, by contrast, are an example of an "inferior good"; people consume fewer spuds, and other low-cost foods, as their income rises.)

Indeed, according to a new survey from the Pew Research Center for the People & the Press, more Americans (40 percent) think that we are spending too little on health care than think we are spending too much (38 percent).

Yet the political elites have a much different vision for health care, putting them at odds with the American people.

The left, which has dominated policy debate over health care for a century, is locked in to the vision of a European-style centralized health care system, requiring forced equality in the name of "solidarity." And so, for example, Britain's National Health Service (NHS) has long fought against the practice of "top up" payments --individuals supplementing their NHS benefits with additional health care purchased with their own funds. Slowly, and with great reluctance, the NHS has yielded to public pressure and is allowing such supplements. That's a defeat for solidarity, to be sure, but it's a big victory for liberty.

Meanwhile, here in the US, liberal-left think tanks share the old Euro vision: Everybody should get some, but nobody should get too much. The Center for American Progress (CAP), for example, makes clear in the "Where We Stand on Health Care" section of its Web site that "controlling costs" is right up there with "expanding coverage" as a top priority.

Interestingly, the liberal argument is mirrored on the right: Conservative think tanks agree that we are spending too much on health care. The Heritage Foundation, to name one, doesn't share CAP's affection for European-style regimentation, but its experts --and the donors who pay the experts -- do have a fear of higher health care costs, which could lead to greater expenses for both business and the taxpayers. And so on its Web site, Heritage specifies "lower costs for Americans" as a major objective.

So while CAP and Heritage might not agree on the means, they do agree on the ends controlling health care costs. And so it's little wonder that this consensus on cost-control has trickled up to the top, to the White House, where Barack Obama wants to enact a "bipartisan" health plan, if at all possible. The president laid out his policy vision to the American Medical Association on June 15, declaring it, "One essential step on our journey is to control the spiraling cost of health care in America." Obama continued, "Today, we are spending over $2 trillion a year on health care --almost 50 percent more per person than the next most costly nation."

To the elites-- left, right, and White House -- such spending is a terrible thing and needs to be restrained. But as we have seen, the American people don't agree. And as an aside, we can only imagine that the slim plurality of Americans who told the Pew Research Center that we should spend more on health care would be a thumping majority if such a view weren't so contrary to "respectable" elite opinion.Ordinary Americans, lacking think tanks and bully pulpits to speak for them, might be shy about telling pollsters their true opinion, knowing that their political opinion is deemed politically incorrect by the experts. But when the crunch comes, in terms of their own budgets and their own personal choices, folks are willing to spend whatever it takes for the health care they want. And as for the wealthy, such as Steve Jobs, they don't need think tanks to plead their case; they just write a check and do what they wish.

But now an even larger crunch is coming: the clash between the elite and the people over national health care policy. The Obama administration, and Democrats in Congress, are pushing hard for a bill that will control costs, which is not what most people want. And Democratic denials notwithstanding, it's not hard to see that rationing is part of their plan, as part of an overall effort at both supply- and demand-reduction.

But the public is resisting. Support for ambitious "reform," of the kind put forward by liberal Washington wonks, is already wilting; the same Pew Research Center found that just 41 percent of Americans today think the health care system needs to be "completely rebuilt," compared to 55 percent who thought so in 1993. And of course, back then, "ClintonCare" was defeated. So what will happen this time around? Stay tuned. But Democrats are nervous.

The basic issues are these: Health care is a superior good. If people have more money, they will spend more of it on health care. Steve Jobs points the way to a longer-lived, but costly, future.

In the words of health expert Shane:

"Bravo to Steve Jobs for pursuing the best treatment that American medicine can provide. We talk about a desire for better health care -- which for each person is really about genetics, diet, lifestyle, and environment -- when what really counts is the ability to access the best medical treatments, which are a function of technology, physician skill, and hospital care."

And, of course, money. Obviously, the rich will never allow themselves to be herded into a health care system that prohibits "top ups." And so the question: Will the near-rich allow themselves to be so herded? And how about the wannabe-rich? And the downright not-rich? And those who merely want to live? Most likely, all but the hardest of hardcore left-wing ideologues will rebel against government-run healthcare, sooner or later.

As Jim Woodhill sees it, the health care elite has the wrong intellectual model in its head when it comes to health care: a vision of managing scarcity. If, as he says, health is war, then that war will require a kind of national mobilization that will not be cheap. But if such a mobilization is what people want, then it will be popular. A vote-getter, as they say in Washington.

Of course, death cannot be defeated in the end. So does that mean endlessly escalating costs in a war that can't be won? Woodhill's argument is that productive life can be greatly extended through what he calls "serious medicine" that is, one battle, one breakthrough, at a time. And when that happens, just as in warfare, technological advances can make victory both easier and cheaper. As an illustration, Woodhill cites the case of President Dwight Eisenhower, who suffered a massive heart attack on September 24, 1955. The doctors' prescription for the 64-year-old patient was simple and minimal: bed rest. As important as Ike was, there wasn't anything else that doctors back then could do for him, even if his good health was a vital national security concern in that Cold War era. But the minimalist medical status quo soon changed; by the 1970s, open heart surgery was common. Such procedures were, of course, hugely expensive, but they were effective and popular.

But since then, further advances have greatly reduced the cost of heart disease. Using a bit of business jargon, Woodhill calls it "getting to the right side of the experience curve," that is, getting over the hump of higher costs to a declining slope of expenses and difficulty. Robots can now do some minimally invasive heart surgery, through a much smaller incision into the chest -- good news for patients, and for payers. Also, stents allow doctors to clear cardiac blockages by remote control. Down the road somewhere, nanobots might be able to perform the "roto-rooter" function on a routine basis.

The upfront cost of such nanobot technology will be huge, of course, but if the technology could be mass produced, costs would fall to widget levels. It's in the nature of mass production that the prototype of anything is fantastically expensive, whereas the latest unit rolling off an assembly line is terrifically cheap. The challenge is to support the initial investment, allowing for a long-term payoff in terms of both health care improvement and cost-crash.

And that's just medical machinery. Wonders have also been wrought by pharmaceuticals that cost billions to develop, obviating surgery altogether. What else can we look forward to, in terms of more drugs, or stem cells, or particle beams or some completely new kind of breakthrough?

But we'll never find out what new medical miracles are possible under the current intellectual-political reign of the elites, for whom "controlling costs" is the agreed-upon goal. Yes, such high-tech breakthroughs might cut costs in the long run, but all too often, politics operates in the short run. And in that short run, health-care-crats will be looking to cut, so as to make the overall cost of a national health care plan appear as low as possible. More deeply, the guiding vision of regulated, regimented one-size-fits-all scarcity, which animates the left, does not allow much enthusiasm for "heroic medicine."

But hold on a second here. The elites don't get to decide these questions; here in America, the people rule. And that popular reality spells trouble for the Obama agenda in 2009. Moreover, public opinion will prove to be an obstacle for any politician or party, from the right as well as the left, that pushes an agenda the voters don't want.

The American people haven't found their voice yet, but when they do, they will endorse a health care system where expenditures rise, not fall. They will support an overall "war" on the maladies they fear and dread. The only question is, How long will it be before the political elites accommodate the public's wish?

But in the meantime, Steve Jobs, paying for his costly but successful treatment, is pointing the way to the healthy future Americans actually want.

Paul Baxter knew he was unwell when he suddenly developed severe pains in his stomach. ‘I felt like someone was stabbing me. The pain was so bad that I was crying,’ he recalls. He was baffled and worried. But his GP put his mind at rest by insisting that it was a bad stomach upset and prescribed some strong anti-indigestion pills.

Seven months later Baxter, 44, a travel agent, learnt the truth. He had testicular cancer, which by then had already spread to his stomach and chest. Despite Baxter suffering serious weight loss and constant tiredness – classic symptoms of cancer – his GP, another doctor at the surgery and staff at his local hospital in Runcorn, Cheshire, had all failed to diagnose his condition.

Just an abberation right? This can be something that happens all the time. The fact is, they don’t know how often it happens. They don’t keep track of that kind of thing. But there are some interesting numbers from “unpublished research”:

Previously unpublished research by the Department of Health and the National Patient Safety Agency watchdog reveals that some patients with cancer have waited for 23 months before their illness is correctly identified and treatment begun. The study also uncovered 1,916 cases in 35 months where a cancer patient had suffered a late or missed diagnosis, an average of 55 people a month. But the agency admits the figure is a serious underestimate.

Fifty-five people a month, not diagnosed appropriately.

So what happens if you get diagnosed with cancer in America, where we don’t have socialized medicine? Turns out, you have a better chance at beating it:

According to the survey of cancer survival rates in Europe and the United States, published recently in Lancet Oncology:

* American women have a 63 percent chance of living at least five years after a cancer diagnosis, compared to 56 percent for European women. [See Figure I.]U.S. Cancer Care Is Number One. fig1
* American men have a five-year survival rate of 66 percent — compared to only 47 percent for European men.
* Among European countries, only Sweden has an overall survival rate for men of more than 60 percent.
* For women, only three European countries (Sweden, Belgium and Switzerland) have an overall survival rate of more than 60 percent.

These figures reflect the care available to all Americans, not just those with private health coverage. Great Britain, known for its 50-year-old government-run, universal health care system, fares worse than the European average: British men have a five-year survival rate of only 45 percent; women, only 53 percent.

Forty-nine percent (49%) of U.S. voters now at least somewhat oppose the health care reform plan proposed by President Obama and congressional Democrats, while 46% at least somewhat favor it, according to a new Rasmussen Reports national telephone survey.

Just two weeks ago, 50% were for the reform plan, and 45% were opposed.

The “nays” also continue to have the edge in terms of intensity. While 22% strongly favor the Democrats’ health care reform plan, 38% strongly oppose it, up four points from the previous survey.
Among those voters who have health insurance, opposition is even higher: 43% favor the plan, but 52% oppose it. Those who strongly oppose it outnumber those who strongly favor it by two-to-one – 40% to 20%.