Thursday, July 30. 2009
In neither the House draft nor the various Senate drafts of health care legislation can one find any tort reform. According to reliable sources, the excess costs of “defensive medicine” due to providers’ fear of law suits is 9-10% of our total national health care spending. Just capping punitive damages has led to a 3.4% reduction in per capita health care spending in those states with caps. In California, with a cap, malpractice premium increases have been 75% lower than nationally, and claimants collect in 1/3rd the time as elsewhere.
President Obama promised the AMA convention that he would support reasonable tort reform. So far, he like Waldo cannot be found on this issue. Patients do have a right to justice when due. Tort attorneys do not have a right to a cornucopia of claims.
News reports have followed the health industry players involvement in the legislative drafting, but nothing has been reported about tort lawyer lobbying. Perhaps they don’t have to lobby, as about half of Congressmen and Senators are lawyers, and only a very few are doctors.
On the other hand, if government runs all health care, try suing it. Ha!
Oh! Did I forget to mention that in the 2008 elections 76% of lawyers contributions went to Democrats, and 84% so far in the run-up to the 2010 elections?
And, Oh My! Then there's this move in Congress of a $1.6-billion tax break for lawyers. Just what we need, having the government make it easier for lawyers to launch more frivolous or speculative cases.
 Like Massachusetts, Maine decided to try its own government medical insurance plan. Betsy recounts the grim outcome of that effort.
It's not your grandfather's Maine anymore. 23% of the state is on Medicaid - which is welfare. Whatever happened to the gritty, independent New Englanders? And why don't they pack up the U-Haul and move to Texas, where there are jobs, low taxes, and opportunities?
Nobody imagines that a good job market will ever return to Maine with their current politics, taxation, and increasingly decadent culture. What are the people waiting for?
Some new disturbing info about ACORN (which recently has been the recipient of how many billions of "stimulus" money, and which is supposed to be part of taking the next census).
This needs to be stopped. This is creepy.
 First they came for the hamburgers
Canada no longer has free speech
At Volokh:
Judge Richard Posner thinks the proposed Consumer Financial Protection Agency Act of 2009 goes overboard in trying to protect consumers from themselves. Better to treat them — us — as "consenting adults."
Why do people in government think we citizens are idiots? ...but maybe we are, if we voted for these jokers.
From Dr. Bob:
What is it with these so-called policy gurus? Knowing little or nothing about how health care really works, they haul out the bromides and throw around statistics based on taking small numbers and projecting them across large populations, to come up with scary percentages which then echo around the web and inside the hollow heads of the parrots in media newsrooms. Oh, and our politicians then use this crapola to formulate policies, which always end up having massive unintended consequences and which never achieve the results promised. Newt’s a pretty bright guy — generally a far better idea man than a politician — but he’s whiffing at softballs thrown slowly, by and large, with this one.
So what’s my gripe? Where do I begin? How about at the beginning?
Kaus:
Here's a safe political prediction: Despite all the innovative e-mobilization and ad campaigns and town halls and community organizing, the August recess will not produce any effective groundswell of popular support for Obama's health care reform.
Joe Biden has me scratching my head. Powerline
Are the Dems in trouble in 2010?
Prof Gates happy for a chance to play the Race Card. John Stewart. Related: MSM covers for Gates
Related: Prof Gates has a summer home in Oak Bluffs on Martha's Vineyard, which is the village the O wanted to vacation in too. Many do not know that Oak Bluffs has been a favored summer spot for affluent black Americans for a century. Martha's Vineyard also still has a good population of Wampanoag indians, mostly in the Gay Head area.
More on the obesity ridiculousness. Q&O
In which Dan Rather beclowns himself
“Wenn ist das Nunstruck git und Slotermeyer?" Driscoll
Wednesday, July 29. 2009
How many people really imagine that Presidents and Washington have power over the economy?
Governments, of course, only really have power to damage economies. Economies have lives of their own, following their own natural laws like weather. Even the Almighty Fed is very limited in what it can do.
Still, people seem to think that Presidents are somehow responsible, and I suppose that is because politicians seek any advantage, no matter how insincere.
Neither Bush nor Obama are responsible for the recession. It's called a "business cycle." People are blaming Obama now, and the O is trying to blame Bush. It's all stupid boob bait.
Besides cycles, what has the power to damage economies is government intervention like taxation, deficits, subsidizing of failing businesses, and regulation. Those things hobble economies, holding them back from what they naturally want to do (which is to produce things, including labor, and to price them), and I have no doubt that businesses have been worrying about what the Dems might do to hobble them.
Lefties always seem to love wealth and money, but to have contempt for those who create those things. Most of the very wealthy people I know are Dems or "Independents."
I posed this question to a very nice, well-intentioned but scientifically-illiterate Greenie lady I sat next to at dinner on Saturday night:
"What if there really is scary global warming, but it turns out it isn't caused by man, but instead by natural variation from other factors that are too complex to be understood? Then what?"
There was no reply. Her brain appeared to short-circuit.
I am a fun dinner companion.
Our Constitution begins:
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
From the earliest days of our Republic, we’ve considered and argued ways to improve its representation of citizens. We are a Republic, of elected representatives, not a direct Democracy (except in some states with direct initiatives to be voted upon).
In either case, legislation voted upon by legislators or directly by voters, the complexity of the issues at hand and of the language to express it, compounded by the number of pages of fine print, the confounding interactions, and the many unknowns, makes the task of understanding and judging often Herculean, Solomonic and Einsteinian all at once.
The strength, wisdom and knowledge of Hercules, Solomon and Einstein are simultaneously required when considering thousands of pages of tiny-type recasting 1/6th of the US economy and 100% of the health care received by 100% of our citizens. Put health care legislation together with the rushed economic legislation of the past 6-months, and we’re talking about 1/4th of the US economy recast. Add in the changes in tax code to come to pay for it all and you’re well past ½ the US economy remodeled. Literally everyone in the US, and indirectly most of the world, will be directly and seriously affected.
We’ve toyed with various adjustments, some legislated and some voluntary (usually obeyed only at the convenient whim and self-interest of elected representatives) to increase the deliberation and independence of legislators, and allow the public time and information to weigh in. For the most part, they’ve failed or been inadequate.
Not that they will be the ending solution, I’ll propose some more to bolster our and our legislators’ ability to make sounder decisions:
1. All members of legislative committees, entrusted by other legislative members with the detail evaluation of legislation, must attend all open and closed door meetings. That leads to wider and more careful deliberation. This duty is paramount over prestigious memberships in too many committees to be able to perform adequately in each.
2. All legislation must be publicly published on the Internet in full at least several weeks before detail hearings, to allow even minimal familiarity by those affected, the more knowledgeable, and by the public who has the right to transparency in order to know.
3. All legislative committee hearings must hear from an equal number of experts chosen by each political party, regardless of the weighting of party membership on the committee, to increase the likelihood of more information and views being heard.
4. All the members of each legislative committee must vote and publicly explain their vote.
5. All legislation funding or affecting more than one agency of government must either be broken down into its components for separate votes or be held for vote in the next biannual Congress once the public vote weighs in indirectly on the information received from hearings and legislators’ positions.
Yes, these reforms may slow some legislation, but experience with untoward consequences of haste and shadows makes that a positive result. Yes, these reforms will shift the workload of legislators toward deeper involvement with the details of legislation, the benefits of that being evident. Yes, true crises may require quick action at times, and if so there’s nothing to stop wise legislators from breaking such legislation into more carefully constructed and deliberated parts.
Yes, we can have a more perfect Union, more perfect Republic, closer to Democracy and to the capabilities of Hercules, Solomon and Einstein.
 Steyn wonders Isn't it Islamophobic to characterize Palestinians as homophobic?
Insane: A European Working Time Directive. How do people put up with this BS? Doctors work when they have to. That's what doctors do. That's what all vigorous people do, except for Euro-weenies. I sure hope their rules do not apply to farmers, shop-keepers, or entrepreneurs.
Now I understand: they permit morons to vote in California. Video. h/t, Neptunus
How can you have a medical insurance poll when only 6 people in the US know what's in the bill? Are people taking it on faith? Gotta love this line:
Pg 425 Lines 17-19 Govt will instruct and consult regarding living wills, durable powers of atty. Mandatory!
No laughing out loud at Dr. Obama. It's a cartoon, for heaven's sake. Woops, I forgot. The Moslems made cartoons dangerous. I feel sorry for that neurosurgeon, who was just having a little fun.
Bruce Walker at Am Thinker asks Is the O's Presidency unraveling?
Tuesday, July 28. 2009
 One year ago, I parked my car (legally - no No Parking signs) on the side of the road to eat my take-out Thai lunch as a break from the office, while admiring a lot full of fancy used cars.
Cop pulls up behind, turns on flasher. "What are you doing here?"
"Eating my lunch and looking at the pretty cars, officer."
"License and registration, please."
"OK. Here they are." (Goes back to his car to check it all, then returns)
"You need to move along."
"WTF? F-you. I'm an attorney, and I am doing nothing wrong. What's the matter? Didn't get any last night, ahole?" "All right, Officer."
I happen to be white. Policing happens to everybody, and sometimes it is a damn annoyance and ridiculous. I decided not to send a letter of complaint, because they might be on the lookout for my gold-plated Rolls 5 year-old Lexus sedan after that. You have to use your brains: cops are your employees, and they are pros, but also pricks sometimes.
As an attorney, when a police officer stops you and says "I smell alcohol on your breath. Have you been drinking?" the correct response is never "Officer, I see powdered sugar on your chin. Have you been eating jelly donuts?"
A guy named Fleckman is going through the Dem insurance proposal page by page. A few samples:
Pg 22 of the HC Bill MANDATES the Govt will audit books of ALL EMPLOYERS that self insure!!
Pg 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments and benefits you get
Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE IS RATIONED!!!
Pg 42 of HC Bill - The Health Choices Commissioner will choose your HC benefits for you. You have no choice!
Pg 50 Section 152 in HC bill - HC will be provided to ALL non US citizens, illegal or otherwise
Pg 58HC Bill - Govt will have real-time access to individuals' finances and a National ID Healthcard will be issued!
Pg 59 HC Bill lines 21-24 Govt will have direct access to your banks' accounts for election funds transfer
Pg 65 Sec 164 is a payoff subsidized plan for retirees and their families in unions & community orgs (ACORN).
Pg 72 Lines 8-14 Govt is creating a HC Exchange to bring private HC plans under Govt control.
Pg 84 Sec 203 HC bill - Govt mandates ALL benefit pkgs for private HC plans in the Exchange
Pg 85 Line 7 HC Bill - Specs for Benefit Levels for Plans = The Govt will ration your Healthcare!
Pg 91 Lines 4-7 HC Bill - Govt mandates linguistic-appropriate services. Example: Translation for illegal aliens
Pg 95 HC Bill Lines 8-18 The Govt will use groups (i.e., ACORN & Americorps) to sign up individuals for Govt HC plan
Pg 85 Line 7 HC Bill - Specs of Ben Levels for Plans. #AARP members - your health care will be rationed.
Pg 102 Lines 12-18 HC Bill - Medicaid-eligible individuals will be automatically enrolled in Medicaid. No choice.
pg 124 lines 24-25 HC No company can sue GOVT on price fixing. No “judicial review” against Govt Monopoly.
pg 127 Lines 1-16 HC Bill - Doctors/ #AMA - The Govt will tell YOU what you can make.
Pg 145 Line 15-17 An Employer MUST automatically enroll employees into pub opt plan. NO CHOICE
Pg 126 Lines 22-25 Employers MUST pay for health care for part-time employees AND their families.
More of the details here. I hope Mr. Fleckman keeps the details coming, because the MSM is not - and neither are our Congressmen.
The folks who brought you the War on Drugs, The War on Poverty and the War on Cancer now want to win the War on Obesity.
I wouldn't give a darn, except that this useless Nanny nonsense is on my nickel.
The Dems never listen to my advice.
I have advised them several times over the past years to do something very simple: put every American citizen on Medicare, and raise the Medicare tax as needed to cover the costs (with no employer contribution, however - purely from the income-producer. The Medicare FICA tax is currently 2.9% on all income: all they'd have to do would be to double it or at most triple it, I imagine, since the older folks who cost most of the money are already on Medicare. Thus if you make $50,000 you would pay around $4000, and double that for $100,000).
Was my suggestion too simple?
Mind you, it is not what I would like to see done, because it would put an instant government stranglehold on our medical care, medical research, the drug and biotech industries, etc - not to mention threatening the survival of Docs and hospitals. And not to mention politicizing medicine.
But since the Left loves to control things centrally, I have no idea why they didn't do something so obvious and easy.
 Of your tax dollars to produce one, one-week job. That isn't efficiency, in my book. Wouldn't a tax cut have worked better?
Or a $50,000 check mailed to each American? That would have surely produced a short-term stimulus...altho I believe economic cycles heal themselves anyway, and best, without government intervention, just like everybody gets over the flu after a while except those who were already dying.
If the US Treasury had sent me a $50,000 check (shamelessly borrowed from my kids and future grandkids), I would have bought myself a used S&W .45 revolver for $700 to shoot beer cans off a big old log, and used the rest to pay off kids' college debts.
And around $1500 of it to bring our veterinary account up to date. Vets are paid better than Docs these days.
 Extreme kayaking. No thanks.
Michelle's new book: Culture of Corruption
The surge in American gun-buying
How to defeat socialized medical care. Vid at PJTV
Prof Gates: Another Lefty tax conniver? It figures.
From Herbert London on the Crisis Syndrome:
It is customary for politicians to describe an issue that is important to them as a problem. After all, problems require solutions, and solutions get them elected.
Rarely, if ever, will a politician describe a “condition” because conditions occur in the natural order and aren’t subject to positive intervention.
The Obama administration, however, has a new tactic, one that has raised the level of concern and the need for action. It describes every issue as a crisis. For example, we don’t have an unemployment problem, we have an unemployment crisis. We don’t have a healthcare problem — it has escalated to a crisis.
Moreover, if a problem is regarded as a crisis, the government must act immediately. No time to tarry.
Oh, no. Housing Reform now?
We ask again: What does abortion have to do with medical care? I have no interest in paying for anybody's abortion.
Raising the minimum wage led to fewer jobs for young people. Of course it did.
A young woman's political education. Pajamas
Another excellent analysis of how the left-leaning Dem Congress works these days
California has 32% of the nation's welfare recipients. Hmmmm.
Cronkite wanted world government. h/t, Driscoll
From Ace:
Obama, as has been noted widely, is willing to sign anything called "Health Care Reform," just as long as his ego gets its big win.
Which is sort of a problem. Because I really can't see these idiots doing anything helpful. Quite the opposite. So I'd rather Obama stood firm and vetoed anything that didn't contain his "transformative" system-destruction provisions.
The Democrats seem to be watering this down enough that it might end up getting passed. In all likelihood it will still be all kinds of bad. Just not all kinds of bad enough to prevent passage.
You know how this works. Government intervenes, makes a mess of things, then tries to ride in as the ones who will fix it.
Photo from Theo. I wish to surrender!
Monday, July 27. 2009
 If there's a more loathsome person in the news right now than Henry Louis Gates Junior, I've missed them. It's amazing the amount of attention you can get playing your one-note piano with your foot on all the pedals for the media and academia these days.
Listen to him for a minute and a half, and you can see he's a second-rate intellect with a third-rate sense of respect for his fellow man. Perfect for Hahvahd, now that I think of it. Just like the Widener-shunning alum Teddy Kennedy, only teaching instead of sleeping in class, and driving the affirmative action bus over a cliff instead of an Oldsmobile off a bridge. I can't advise riding with either of them. But then again, a policeman responding to a burglary call isn't in a position to skip talking to Skip. Being wrong at the top of your voice, and a jerk in the bargain, is the sum total of the prestige the Harvard nameplate offers, I guess.
Just when you think you've heard all the drivel you could imagine coming out of the guy's mouth or pen, you hear another topper. According to the AP, on his application to attend Yale, he wrote:
"As always, whitey now sits in judgment of me, preparing to cast my fate. It is your decision either to let me blow with the wind as a nonentity or to encourage the development of self. Allow me to prove myself."
It's really hard to be incoherent, obsequious, and imperious and insulting at the same time, but it appears he's been managing it his whole life. That approach is not without its charms, after all. It's the official foreign policy of the United States right now, for instance.
At about the same time Gates was playing passive aggressive with a Yale admissions office likely bending over backwards to let him in anyway, another man, a much more pleasant and charming man, and a snappier dresser, uttered the same sort of line, but without any malice. Hoping to burst the tension in the words by uttering them along with his fellow man, and he didn't discriminate about who his fellow man was. Viewing the words as an obstacle to get past, not a cow to be milked.
You can only utter half the line now. It's a testament to what Skip Gates and his ilk have accomplished in the intervening years. Everyone used to be able to say both words with impunity, but generally didn't, if for no other reason than it was the mark of bad manners. Now only the pallid portion of the words can be uttered with malice, and often are, thanks to the tireless efforts of Skip Gates et.al. It's still not enough. There will never be enough for the Convent of the Sisters of the Perpetually Afflicted they're running over at Harvard, and in many other, big, important white buildings all over this marvelous country.
Don't call me whitey... Skippy.
A brief Mankiw explanation of his view on government power, in the context of medical care, which echos my views but is more concisely expressed. A quote:
(My) philosophical inclination most likely influences my views of the healthcare debate. The more power a centralized government authority asserts, the more worried I am that the power will be misused either purposefully or, more likely, because of some well-intentioned but mistaken social theory. I prefer reforms that set up rules of the game but end up with power over key decisions as decentralized as possible.
and:
What puzzles me is that Paul (Krugman) seems so ready to trust solutions that give a large role to the federal government. (In the past, for instance, he has advocated a single payer for healthcare.) I understand that trust of centralized authority is common among liberals. But here is the part that puzzles me: Over the past eight years, Paul has tried to convince his readers that Republicans are stupid and venal. History suggests that Republicans will run the government about half the time. Does he really want to turn control of healthcare half the time over to a group that he considers stupid and venal?
Read the whole short piece. Then I saw this interview with Princeton's Utilitarian Philosophy Prof Peter Singer. One exchange in that interview:
Do you really think the government can make choices regarding care fairly and efficiently?
Mr Singer: Since my New York Times article appeared I've had many people write to me with their heart-breaking stories of being denied care, or being unable to afford care, for themselves or for their families .No human system is going to be error-free, but I'm convinced that the government can set up a process that will make choices that lead us to obtain better value for our health-care dollars than the completely uncontrolled system that exists now.
Utilitarians always give me the creeps. It's always about having "experts" in "control" of our lives - preferably them. Speaking of power and control, Kaus makes a comparison with the proposed IMAC with base-closing commissions, with this wise comments:
Why isn't a base-closing style commission the solution to every one of our problems? After all, it's logical that the problems our peculiar system of government--featuring a Congress that gives powerful voice to regional and local interests--hasn't yet solved will be precisely the problems that our peculiar system of government is almost incapable of solving. Otherwise they would have been solved already!
and
The Constitution created an unwieldy system--requiring that every law pass two houses and get approved by the President--that we long ago concluded was incapable of generating the quantity of binding laws a modern society needs. The response was the creation of the administrative state--the "unelected fourth branch of government" that writes enforceable rules subject to nobody's veto (except the lawyers and the courts). At least the base-closing solution grounds the outcome in the consent of elected officials.
The "administrative state." That's the word for it. Like Versailles.
We have often said that American medical costs are a measure of our prosperity, our inventiveness, and expecially our remarkable pharmaceutical and biotech industries which are the envy of the world (and upon which the rest of the world depends).
I hope our friend Coyote doesn't mind our borrowing this from his post:
 Good summary of the legislative stumbles re health care, at Hennessey
World's fastest home internet connection (fixed)
Brit gummint keeps their climate data secret. Why? Related: Some reality about Greenland's ice
Obama care is worse than you think. Wkly Standard
Ben Stein: We've figured him out
What's up with New Jersey? NYT
Shoot the messenger. WH attacks the CBO. I thought the CBO was sacred.
I know adults who could probably use this book too, which Insty mentioned: You Don't Have to Learn the Hard Way: Making It in the Real World: A Guide for Graduates
Is it a crime to have a fat kid? I don't think so. How do you control what a 14 year-old eats? The world has always had fat people. Some people like to be fat, like Pres. Grover Cleveland who admitted to only a prosperous 307 lbs but was probably well over that.
Why the Ricci case complicates - but doesn't kill - affirmative action. Related: Prof. Gates says he's 57% white. Lucianne comments "Guess there's no money in White Studies."
Sunday, July 26. 2009
Via Gateway, re WH medical care advisor Dr. Ezekiel Emanuel (Rahm's brother)
Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, "as an imperative to do everything for the patient regardless of the cost or effects on others" (Journal of the American Medical Association, June 18, 2008).
Yes, that's what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.
That's why they want Docs to be government employees instead of your privately-hired professional.
Synthstuff saw the above and expanded on the topic.
From a Theo piece:
It took Obama six months to pick a dog, but he wants a Health Care Bill by next week?
Who's he kidding?
Does medical insurance represent a market failure? Robin Hanson
Related: When politics replaces market forces.
 The importance of good conversation. AVI
Nostalgia for racism.
Liberals should be fighting white stereotyping. Driscoll
Review the darn checklist before landing
Victory was not a dirty word in the election. So why now?
The coming middle-class tax hikes. Related: The freedom you would lose under Obamacare.
Some good news from Africa. Front Page
This recession has more government policies that discourage work. I have heard this, around. Take a sabbatical and stretch out that unemployment. Or find some disability if you can.
Hypocrite du Jour: Thomas Friedman. Glib and sanctimonious, like so many at the NYT.
Forcing people to get medical insurance who don't want it.
Iraq Powerpoint in the US Army. PowerPoint is lethal, in a way: it's mind-numbing. Powerpoint and meetings are the reasons Coyote quit corporate America to become an entrepreneur.
Saturday, July 25. 2009
Michelle:
Health and Human Services Secretary Kathleen Sebelius tried to reassure citizens in New Orleans this week that Obamacare bureaucrats will make sound medical decisions for all Americans. She failed. Under the government-run plan, she promised, a team of health care experts will recommend what should be covered: “I think it would be wise to let science guide what the best health care package is.”
I guess it didn't occur to her that doctors know some science - and they also know something else: they know their patient. No two patients are alike. People do not want an "approved treatment protocol" - they want to work it out with a doc who is working for them, and is not a de facto civil servant. I think what Sebelius means is not "science": she means a board of cost-containing medical efficiency experts.
However, I do not think anybody wants a government to have that sort of power. Governments create omnipotent monopolies.
It's one thing for a private medical insuror to tell you they don't cover in vitro fertilization, and another for the government to tell you that you cannot have it because "science says" that it's not cost-effective. In the former case, it's a freely-entered association, as Milton Friedman would say, and if you want the in vitro badly enough, you can save your pennies and get one. Furthermore, I'd much rather make an appeal to a private biz than to the government.
We suspect that the government wants two things: 1. To get more folks on the Government Plantation and, 2. To control Medicare costs. Re the latter, the O might be right that it may have been unwise for his Grandma to have a hip or knee replacement when she was dying from cancer - but he is correct that 80% of medical costs occur in the final year of life. However, unless somebody has terminal cancer or something comparable, how do you know it's somebody's final year of life in advance?
Another related issue is the equating of "health care" (a dumb term) with medical insurance. I suppose with the high costs of medical technology and hospital treatments, those costs are out of reach for the average person (which is why we buy cheap catastrophic, ie high-deductible medical insurance) but, for most purposes in life, a regular office visit for a bad sore throat or a camp physical doesn't cost very much at all, while an ER visit for your bad sore throat can set you back $750.
We agree that it is foolhardy for anybody who is not wealthy - especially for a family - to carry no catastrophic major medical insurance, because bankruptcy sucks. We also think it is foolish for people to expect insurance to cover every office visit: the whole point of insurance is supposed to be that you hope you never need it.
However, years of Medicaid (for the poor), Medicare (which pays for everything, at low rates), union-driven medical benefits and work-related medical benefits have produced a sense of entitlement and, we would argue, have driven up the cost - and the quality - of medical treatment in the US.
What is the right role for government in medical care? We don't know, and we don't trust anybody who says they know. Fact is, government already controls much of it via Medicare, Medicaid, and now SCHIP. It has been incrementalism at work, with the long socialist view. One thing we do know is that fewer and fewer Docs want to accept Medicare, and few ever accepted Medicaid except for charity clinics and inner city Medicaid mills staffed by foreign medical graduates.
Why do so many Docs opt out of Medicare? Because of the paperwork requirements and the unsustainable rates of reimbursement. When people get a doctor's bill, they often forget that it's not a bill for his time: it's a bill for his rent, his machines, his two nurses, his insurance coder, his bookkeeper, his receptionist, his staff's benefits, his malpractice insurance, etc. Your local Internist and Pediatrician is not getting rich on $65 office visits these days. In fact, they are struggling.
No, the big costs are tests, some medicines, hospitalizations, cancer treatments, dialysis, the ICU, etc. The big ticket items - and those costs are not compressible. They can only be rationed if costs are to be cut. We do not think those costs should be cut, because we believe that such decisions are a matter of personal choice and freedom and, as they always say, "All you have is your health." Or your disease, as the case may be.
We wish we knew the right answers to all of these issues but, despite the problems, we will say one thing: With the best, most innovative and most available medical care in the world, one must be extremely careful about messing with it. Freedom is always messy. We re-link Cardinal at Tigerhawk's defence of American medicine.
From another point of view, a quote from an annoyed Vanderleun's Who, Whom?, which reiterates our Roger's thoughts about The Plunder Economy:
Who—whom?" Who shall be forced to give up the health care that they like (most Americans), and whom shall receive health care they (supposedly) ain't got -- for free -- at a cost to everyone else of trillions in dollars and immeasurable quantities of freedom and privacy and security.
Who (shall give)? You and hundreds of millions of others. Anyone who has a job, or makes things, or owns things that can be taxed. And then have a fee for this or that levied (for the common good). And then taxed again.
Whom (shall receive)? The poor shall be marched to the front of the line; their ragamuffin children with protruding bellies on their shoulders for the photo-op. But right behind them will come.... the slackers, the lazy, the whacked-out, the grifters, the hustlers, the useless, the career recipients of endless government hand-jobs, the hard-core unemployable, the 17% of crack whores that do not work for the government, and a few million others that form the hard, adamantine core of Obama's and the Democrats' aptly named "base."
"From each according to his ability, to each according to his needs," is what's going on here. Except this time the add-on is "Even if you don't need it or want it, because little Susie the crack whore does. P.S. We're gonna slip in some language to pay for her abortion too, just because it will piss you off."
That is a bit cold, Mr. V.
Written by The B and BD together.
Friday, July 24. 2009
Away this weekend, but here are a few links I want to get out there first:
It's better to be tall. I always wanted to be 6'3, and now I see why. I blame my parents.
Academic Groupthink.
I'm bipolar. Cut me a break.
Missed this: The Pope on Love in Truth.
The O's fate depends on Perot voters
Why should our tax dollars be going for stuff like this?
Civil war: Black Caucus vs. Blue Dogs. Where does the Irish Caucus stand?
Gov. Pawlenty: This was a joke on the American people
If Bush made this sort of factual error. What a phoney, as Holden Caulfield would say.
Gov. Perry of Texas, standing up to The Man. That is an American thing to do.
The Krautman on why Obamacare is sinking. One quote:
...the greatest waste is the hidden cost of defensive medicine: tests and procedures that doctors order for no good reason other than to protect themselves from lawsuits. Every doctor knows, as I did when I practiced years ago, how much unnecessary medical cost is incurred with an eye not on medicine but on the law.
Tort reform would yield tens of billions in savings. Yet you cannot find it in the Democratic bills. And Obama breathed not a word about it in the full hour of his health-care news conference. Why? No mystery. The Democrats are parasitically dependent on huge donations from trial lawyers.
Related: How the O stumbled. WSJ
Related: Medical care? Few care all that much.
Just for laughs, I want to hear these tapes. Related: If he's so smart, how come the Prof doesn't know these basic facts?.
Related, from Rush: "The only racial profiling in Cambridge Massachusetts is in the Admissions Office of Harvard University."
Watch for the OFA to come knockin' on your door
VDH on how the O could have done things right.
The O's problem: Glibness. Powerline:
(he) continues to overestimate his verbal skills. All his life, he has been rewarded for assuming a certain pose and offering up platitudes in a reasonably glib fashion. These are minor talents at best, but they got Obama elected President, notwithstanding his lack of original insight into any issue of public policy. Now that he is President, however, these limitations are starting to haunt him. Obama's foolish and entirely needless assertion that Cambridge policeman James Crowley "acted stupidly" when he arrested Harvard professor Henry Gates is beginning to turn into a political issue that will hurt Obama with broad sectors of the electorate.
Driscoll reported this, and it sounds right to me:
Carol Platt Liebau (Harvard Law Review), February 20th – “[Tom Pirelli] did most of the day to day work. Barack Obama was nowhere to be seen. Occasionally he would drop in he would talk to people, and then he’d leave again as though his very arrival had been a benediction in and of itself, but not very much got done.”
The guy likes to slide over the surface. That is a character trait.
How to pay for the O's plans? It is beyond parody. Related, from Willisms, below:
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