Health Care Question Time: Swampland Gets Answers

This is very trivial and I am probably the only who will whine about this but, do we need to take up donations to get you people some webcams? Is it a bandwith issue? Why can we not have some visuals KT?

Oh, and good discussion. Thanks.

I like to maintain an air of mystery; besides, this way I don’t have to comb my hair.

Well, I don’t see much interest. LOL. Healthcare was stillborn.

http://ikejakson.wordpress.com/2010/03/24/a-common-sense-healthcare-solution/

KT, thanks / props for podcast, highly detailed answers …and naming Assurant for their coverage-denying practices.
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re: videos, agreed, let’s see more videos here. Even better, let’s increase TV face time for you and the team. You and Jay get some at Wash. Week and Tweety, but let’s expand it and add Amy and Katie. Once I suggested a CNN news show with all four of you. Ditto for the four guys (casual / sports themed?).

KT, thanks to your detailed answers, hopefully these will inspire new questions / ideas / reading tea leaves. As states design their own exchanges, I wonder about the fallout as, ahem, I mean, if some R states footdrag / resist the new exchanges (besides now trying to sue the laws away – aka judicial activism, which conservatism is supposed to oppose, but I digress).

re: doctors accepting Medicaid patients, I want payments increased. Or do we need carrots / sticks? The carrot: more payments. The stick: state boards make all doctors accept a min. # or % of M-patients to renew licenses. The states can require things like continuing education and community service for licensing (in many fields), so why not this?
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That’s all I can think of early in the morning before heading to the cat shelter (volunteer stuff). Thanks again, KT.

“The states can require things like continuing education and community service for licensing (in many fields), so why not this?”

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And the progressive / socialist / social justice whine from the left continues.
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What is next decon? Let everyone work for the Government, and have the government take care of all our needs? Oh that’s right, we are already headed in that direction with Obambi.
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And they wonder why people are so upset and angry.

Sorry, rusty, but you need to whine incessantly, ahem, I mean complain respectfully to state boards. Licensing of doctors, engineers, etc. is a state issue, NOT a Federal one. There is no govt. takeover thru routine licensing. There are some quasi-Fed exceptions, such as NCARB (Nat. Council of Arch. Registration Bds.) which has all state boards as members. It issues a certificate that many states require for licensing, but the state has the final word. Read this again, dear. Licensing is a state issue, NOT a Federal one. And “states right” is a classic conservative them, no? Is this clear enough for you? But thanks for your humor this morning. I enjoyed it.

corrected: “…‘states rights’ is a classic conservative theme…”
KT, fyi, there was a midnight symposium on spelling and grammar at Jay’s last post, thus my self-correction. I’m done.

http://whitecollargreenspace.blogspot.com/

http://www.ireport.com/docs/DOC-424468

Health Care Bill Part 2: A Plan to Help the 25 Million Left Behind
How do we explain to our children that we tried for 100 years to get universal health care and the bill signed by President Obama on 3/23/10 still leaves 15 to 25 million without health insurance. In America money rules. We have stooped so low that we can spend billion$ to keep financial and manufacturing corporations and foreign countries alive but we cannot do the same or our friends, neighbors, and relatives. Corporations can’t feel pain, they don’t leave loved ones, they don’t serve in the military, they can’t show compassion, and they usually avoid taxes and can write off their bad debts.

Here is a proposal that will save the Federal government close to $50 billion per year enough to pay for the public option with only an executive order. Most office space is very expensive yet white collar workers only use it 8 hours a day, 5 days a week. This amounts to only 30% efficiency which is completely unacceptable in today’s economic and ecological environmentWe can no longer afford to let all white-collar workers that still have jobs work banker’s hours when we can work two shifts per day in government and private industry and cut our overhead costs in half. This simple paradigm shifts solves three problems: It jumpstarts economy and fights poverty, cuts pollution, reduces budget deficits.

As stated previously, UNTIL your physician base buys into this ridiculously complex HCR (thank you Democrats) it is never going to work. So far, FEW of us have swallowed the bait. We were largely ignored during this debate and once again, lawyers get to make all of the rules. This is no longer a government OF the people, it ignores the WILL of the people and mandates draconian change with NO concern about the expense. The next step should be obvious to everyone…FORCE physicians to accept whatever measure the government dictates. When this happens, we cross the line into a full fledged government take over of health care in this country. This, ladies and gentlemen, would be an unmitigated disaster. You will now take a number and wait your turn for a considerably less efficient health care delivery. Good luck with that!

If you’re suggesting that the Federal government mandate double-shifts for managerial workers as a solution health care coverage costs, you’re either a troll, a lunatic or a Stalinist.

So far, FEW of us have swallowed the bait.
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The AMA and the AARP have endorsed the bill, so I don’t think I believe you.

The AMA represents less than 30%of physicians and the AARP is loosing the small percentage of seniors that it represents. SO START BELIEVING!

Oh little decon, I am not saying it is ONLY an Obama agenda. You are right, that the States are also equally inflitrated with progressive stanist socialists as well. I am merely pointing out fact, not whinning as you suggest.
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Have a nice day!

According to the New England Journal of Medicine, about 63% of doctors supported some form of health care reform in September 2009:
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http://healthcarereform.nejm.org/?p=1790
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So I’m going to go ahead and continue to not believe him.

But thanks, though, for making me go back and check my assumptions. You are correct that the AMA represents about 30% of doctors.

In 37 States, as the liberals and progressives jointly attempt to create an unconstitutional “mandate” to purchase healthcare insurance from a Federal Law is now being challenged by these States.
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Pennsylvania now has a bill proposed to stop the Obama “Mandate” an individual buy insurance.
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The people shall have the right to enter into private contracts with health care providers for health care services and to purchase private health care coverage. The legislature may not require any individual to participate in any health care
system or plan, nor may it impose a penalty or fine, of any type, for choosing to obtain or decline health care coverage or for participation in any particular health care system or plan. Section 4. Freedom of choice in health care.

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So much for Obama’s grand plan and scheme to bring about a socialist national healthcare plan. Despite Democrats attempts to incite anger and animosity towards the Tea Party and Republicans with their lies and accusations, I do not see this issue going away anytime soon. Not as long as States like Pennsylvania are going to enact legislation which prevents the Federal Government from imposing laws on its citizens which are and shall always be unconstitutional.
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http://www.campaignforliberty.com/blog.php?view=26760
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The vast majority of physicians endorse health care reform, cliff, just NOT as it is being presented. This bill COULD have been fixed, but in its haste to claim victory, we have this screwed up mess forced down our throats! Take a poll now among physicians, or better yet, ask your OWN doctor what he or she thinks of HCR as it stands…. I think you will be unpleasantly surprised at the answer you receive. I am on the staff of a large teaching hospital and I can assure you, 95% of us think its a cruel joke being perpetrated on the American public. P.S. jlbrumb is correct. The AMA represents only a SMALL number of physicians and even among that number, MANY disagreed with that endorsement.

Check your reading glasses, chief, I already said that jlbrumb was correct about the AMA.
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And if you could provide some sort of evidence to back up your claims, apart from the purely anecdotal, that’d be great.

I have a question. Do you think required Selective Service registration is constitutional? I don’t have an opinion on this. I’m just remembering my own youth when draft registration was a matter of life and death.

Tell me, deconstructa, you have this grand scheme to FORCE physicians into compliance….what about including lawyers into your equation? How about an arbitrary 30% of ALL clients will now receive service for free!! Lets see how quickly the law gets changed if this happens.

As stated, cliff, start polling physicians if you require additional confirmation. I am voicing a personal opinion, but know, for a fact, that the majority of physicians (among my peers) share this same viewpoint. The O.R. is calling, so no more chat time for awhile.

I am voicing a personal opinion, but know, for a fact, that the majority of physicians (among my peers) share this same viewpoint
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See, that’s what I’m asking you to back up. Understand that I’ve got no reason to take your word on this.

How about compulsory education? There was a great deal of resistance to this when it was first introduced, in Massachusetts, and of course during the Great War of Northern Aggression, when the Union introduced the draft, there were riots that make current protests look very tame. But I don’t know enough history, even about the Vietnam War, to say whether these acts were objected to on constitutional grounds.

Karen, do you or does anyone have any link or articles describing how new HCR will affect Health Savings Accounts ?

Thanks in advance.

Grassley and Hatch go from proposing several medical plans in 1993 and 2007 with mandated purchase for individuals to stating that the current law with the same provisions erodes liberty. Of course we have known they are hypocrites for a long time, this is just more proof.

http://trueslant.com/rickungar/2010/03/27/hatch-and-grassley-poster-boys-for-gop-hypocrisy/

Make lawyers do public defense service to keep their licenses? I love it! Thanks, earl.
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Too bad one of your best ideas is likely meant as snark.

KT: I join decontructiva in thanking you for your podcast and including us in your q&a. I used to be a teacher. Do you know you would have been a great teacher?

Oops. Should be deconstructiva.

“Take a poll now among physicians, or better yet, ask your OWN doctor what he or she thinks of HCR as it stands…”
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Why? Should I assume that they’re less ignorant, misinformed and opinionated than you are?

Now you are on a roll, deconstructiva. Lets expand that horizon to include teachers, firemen, policemen, secretaries, etc. etc. etc. Isn’t socialism a wonderful thing?

So ALL physicians are ignorant, misinformed and opinionated, shepardwong ? or perhaps just those who think differently than you do? From others posts, I know just how narrow minded your perspective is, so your commentary comes as no surprise.

Hey, doc, I’m curious, you say most doctors favor health care reform, just what do you propose? The doctors I know, and I know quite a few, across several generations–as my father and my wife are both physicians–believe that managed care degraded both quality of care and their quality of life. They’re primary care providers (PCPs)–internists, ob-gyn’s, psychiatrists–and managed care has been hardest on them, which is why there’s a shortage of PCPs now. But how is being “forced” into a restructured health-care market worse than being forced onto managed care panels? Personally, I think doctors should unionize so you could stop being pushed around by managers and their lawyers, whether in the private sector or the public. Also, I have to ask, where were you when the debate was forming? I’m not talking about the last year, more like the last twenty (or the last hundred). To say, after the fact, we’re all for health reform, just not this reform, is what the GOP is saying. I admit that the GOP had control of all three branches of government for six years and did nothing, but why have physicians done so little to advance the debate, and were they pushed around in thisnow? Why do only 30% of doctors belong to the AMA? If the membership were, say, 80%, the outcome might have been different, but whose fault is that?

Third sentence from end should read, “but why have physicians done so little to advance the debate, and why were they pushed around in this now?”

Our problem, binkieandmarce, is there are simply too few physicians in congress. I think there are only fifteen or so compared to around 250 lawyers. Guess who is going to win, under those circumstances? We argued for tort reform and were simply ignored. We argued for scholarships to put more medical students on a course for primary care and we asked for a systematic change to work out the wrinkles BEFORE broad, sweeping changes were made. Nothing we said made any difference, our concerns were of NO concern to democratic law makers. Okay, let us see where this goes from here. We are NOT happy with these draconian changes made without physician input. As stated previously, If this system is going to work, you better make darn sure your physician base buys in. If government starts mandating HOW we practice medicine, the ultimate loser will be the American public.

One of my points was that, unless you were a secondary or tertiary provider, like a surgeon, radiologist, oncologist, etc., able to bill for “procedures,” physicians were already “NOT happy” with managed care. This has made more and more med students want to specialize and subspecialize. I’m not saying that this top-heavy restructuring of the medical profession was the main or even a major cause of the unsupportable expense of the system, but I do believe it plays a greater role than torts. And if the medical profession had a better record of policing itself of incompetent physicians, I’d be more sympathetic toward tort reform. Finally, I don’t think there are any insurance or pharmaceutical executives serving in congress, but these groups have no trouble getting what they want. And the two physician-senators who come to mind, Drs. Frist and Coburn, were/are as corrupt as the rest of them. I have no love for lawyers, believe me, but the physicians just seem too disorganized and disunified. I don’t think that, as a group, you really know what you want. It’s true, you don’t have as much money as lawyers and the other groups that push you around, but you haven’t begun to make a case for what you want to your patients or the people, and that’s a real loss for everyone. I’m sorry, but you sound like a victim. It’s unbecoming and certainly won’t get you any sympathy.

newfreedomblog @ 5.4, and earljr@5.7~
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I guess you guys are appointed by me by luck of the draw to be used as springboards for me to say that I am WAY past tired of seeing the “socialsim” criticism thrown around as a swear word to disparage persons, policies, outcomes, and imaginative fears that are NOT, I repeat NOT Socialism nor Socialistic. I fail to see that you properly, if at all, perceive a difference between Socialism and regulated Capitalism.
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I am sure you will try to argue otherwise, and if you do, I shall not retort because there is no end to debate on matters of faith disguised as proven fact, but it is my opinion because what I understand the definition of Socialism to be ain’t anything like you use the term to refer to.
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I repeat: this is NOT an invitation to debate. It is merely a statement of my opinion on the subject. And since yours has been given, I suspect, about 10,000 times already, if you use my post as an excuse to do so again, you will be a boar (sic).
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If you wanted to debate what would constitute poor regulation of Capitalism versus well-regulated Capitalsim, I would find that worthy of public discourse, and I would criticize deconstructiva for any sh given you for doing so.

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I am not asking for your sympathy, binkieandmarce, I am simply stating an opinion…one shared by many of my colleagues. Unless congress mandates how many patients we see, we can effectively derail this atrocious HCR being forced down our throats. If that mandate comes, then the best health care delivery system in the world is dismantled. Obama and the democrats, will have a tough time explaining that one to the American public.

What a play on words, mycophile. “managed capitalism’ equates to socialism, if the government starts telling physicians how many patients we must see to maintain our license to practice medicine. When government starts telling YOU how to run your business and mandates a production schedule that MUST be met to stay in business, then the slippery slope has been crossed to full fledged socialism!

earljr@5.10~
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What a play on words, indeed. I wrote “regulated capitalism”, and you quoted “managed capitalism”.
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I am reponding because of feeling the desire to negate any possible inference on your part that I was obfuscating by hiding behind clever definitions.
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I am quite facile with playing with words when I wish to, and I quite enjoy doing so when the opportunity arises. But, when I do, you will not have to assume that I am doing so in an attempt at secret manipulation — it will be obvious to anyone, even you, that I am playing with words for fun.
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To me, the term “regulated capitalism” means something. To you, apparently, it means something else. I said I would welcome seeing you discuss effective and poor means by which to regulate capitalism. You are not doing that yet, so I assume you are not surprised that I am not yet feeling like you are being very constructive.
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Your response reinforces my expectation that you perceive ANY supervision of Capitalism by government to be “Socialism”. While that may be a popular defiintion of Socialism among many people angry at their feeilng of helplessness and/or the oucome of the last presidential elections or the failure of Congressional Dems and Repubs to work together or their desire to have a bigger slice of the economic pie, or for whatever reason(s), but it it NOT a definition of “Socialism” used by economists and political scientists.
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As a former occupant of an Ivory Tower, I do not propose that those professional academic definitions must be accepted and used by all. But I DO suggest to you that if you wish to be “heard” with greater ease and efficiency, that you abandon the use of terms such as “Socialism” since they mean such different things to different people. Difference in approaches such as “Capitalism”, “Socialism”, “Communism”, “Facism”, “Democratic Socialism”, “National Socialism”, “Naziism”, “Totalitarianism”, “Regulated Capitalism”, “Laisez Faire Capitalism”, “Consensus”, “Democracy”, “Representative Democracy”, “Republic”, etc., are ultimately only meaningful in how, IN PRACTICE, they affect general welfare and/or the welfare of distinct groups or individuals. Because, in practice, not a single one of those systems actually operates the way they are described. By anyone.
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I ‘get’ that you didn’t want to respond to my invitation to discuss good and poor ways in which to “regulate” Capitalism, because, to you that would be like answering the question: “Did you kill your wife with a hammer or a tire iron?” Why would you discuss good and poor ways to regulate Capitalism when, to you, that would be tatmount to discussing good and poor ways to have Socialism?
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A suggestion: Discuss why different policies or tactics are helpful or harmful based upon what you perceive the details of their effects will be on actual, individual people, instead of simply calling them evil because you lump them in with a particular definition of a particular political social/economic/political philosophy.
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You will still find many who disagree with you, but the debate will have more of a chance of focusing on the meat of the matters instead of their headlines.

Precisely what I did without resorting to an onslaught of verbiage. If AND when the government mandates HOW MANY patients I must see to maintain my license (as suggested by deconstructiva) then MY personal rights have been severely compromised. When the government starts setting quota’s in ANY workplace and stipulates HOW you run that business, then “regulated capitalism” is no longer the issue. Socialism is a theory that government OWNS or MANAGES business…this certainly applies if government takes over health care in this country and applying “quota’s” is the first step in that direction.

earlj1@ ~

That was enough of a step in the direction I encouraged that I’m going to try something.
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I DID recognize that your post @ 5.10 included discussion of specific consequences to individuals due to specific elements of specifc law. I left that alone to focus instead on the part which you now repeated again — labelling certain acts as evil because you believe that they are part-and-parcel to a school of thought that you despise.
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At least this time you included some defintion of that school of thought with which you were making that determination. It makes your argument so much more concrete, thank you.
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I actually hoped you would do what you did — return to your specifics and clarify them. I hope decon notices and has the time to respond.
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For my part now, I was intrigued by one of the doors your posts @ 5.5 and 5.7 opened in my mental terrain: The way I see it, physicians and lawyers and electricians and plumbers and building contractors and nuclear-power plant operators and motor-vehicle operators on public property (to name a few) are permitted (licensed) by The State do be allowed to do what is otherwise illegal for anyone to do.
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That sure does not sound to me a description of a “right”, that sounds like a description of a “privilege”. If you are a doctor in this country, you are practicing medicine at the pleasure of the State, not as an exercise of your right to practice medicine. A decision was made quite a while ago that caviat emptor in the patient/doctor relationship was not a sufficient operational principle to minimize the risks sometimes individually and always collectively too likely to allow harms that would unacceptably burden individuals and society.
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We may not like the fact that you are a creation of the State when you practice medicine, and that the State can thus burden you with requirements that limit or direct your choices of action, but consider this descrption of the alternative : Everyone with the freedom to cut people open, or to drive a motor vehicle oncoming yours. In the first case, you would have a lot more competition, and most other people would be playing Russian Roulette. In the second case, even you would have a lot more white knuckes.
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This is not to discuss whether decon’s suggestion would be more beneficial or detrimental on balance. I am not dicussing that yet because I am responding to the characterizations of the issue as you have framed them so far.
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