Medicine: August 2009 Archives

As if we need yet another example of a failed "public option" plan, there comes this one from Maine.

Want a preview of ObamaCare in action? Sneak a look at what has happened in Maine. In 2003, the state to great fanfare enacted its own version of universal health care. Democratic Governor John Baldacci signed the plan into law with a bevy of familiar promises. By 2009, it would cover all of Maine's approximately 128,000 uninsured citizens. System-wide controls on hospital and physician costs would hold down insurance premiums. There would be no tax increases. The program was going to provide insurance for everyone and save businesses and patients money at the same time.

After five years, fiscal realities as brutal as the waves that crash along Maine's famous coastline have hit the insurance plan. The system that was supposed to save money has cost taxpayers $155 million and is still rising.

It only took five years to show taxpayers the public option doesn't work, costs far more than governor and the Democrat majority legislature promised, and is in deep trouble, requiring an increasing amount of scarce tax dollars to support.

Many of the same arguments used to promote Maine's DirigoCare are being used to promote ObamaCare. As far as I can tell the differences in the economics of the programs are small other than the size of the programs, which means the shortfalls experienced by ObamaCare will likely be proportionately larger than the deficit being experienced by Maine. The Congressional Budget Office has already come right out and said Congress and President have seriously underestimated the cost of implementing and running ObamaCare. That members of Congress haven't learned the lessons of TennCare, MassCare, and DirigoCare is disturbing. What's insane is that these same members of Congress want to do the same thing on a national scale, ignoring that they are likely to end up with exactly the same result as the other programs - less care, higher costs, scarce medical resources, and an ever increasing amount of taxpayer dollars to fix the problem of their own making.

There Is A Difference

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One thing I hear again and again during the health care reform debate is how Obamacare will ration health care. Proponents of Obamacare counter that opinion with a claim health care is already rationed by the insurance companies. I think it's time to clear up that canard.

First, government-provided and controlled health care is always rationed. That's how they save money on health care costs.

Second, insurance companies do not provide health care, they merely pay for their policy holder's medical claims. Coverage depends upon the health insurance policy. They are not obligated to pay for treatments or procedures not covered by the policy. But the patient still has the option to undergo the treatment or procedure on their own dime. They are not denied care by the insurance company.

Another misdirection used by the Obamacare proponents is that the free market has failed in regards to health care costs. The only problem with that claim is that the free market has little to do with health care costs because for the most part it hasn't been a free market for over 40 years. Both the states and the federal government skew free market signals with regulations and mandates, which makes them totally useless for setting the market value of various medical services. The prices are, in effect, set by the government, state and/or federal and not by the medical practices or the insurance companies.

The only exceptions to this are those medical practices that do not take insurance. They are the only free market health care practices operating in the US, be they small single physician family practices or certain medical specialties (like plastic surgery and LASIK). Their costs are known, under their control, and their costs are far smaller than the health care industry in general.

That ought to tell us something.
One of the charges one hears made most often about the uprising of angry Americans against Obamacare is that it is funded and coordinated by the GOP or health insurance lobbyists. You see it in the various blogs, forums, newspapers, and so on. And it is, if course, the Democrats making such charges. But why is it something that they do on a pretty regular basis entirely off limits for those on the Right?

In Denver it became quite evident the "bought and paid for" protesters weren't from the Right, but from the Left.

The anti-Obamacare protesters arrived by car, public transit, or shank's mare. The counter-protesters arrived by chartered bus.

The anti-Obamacare protesters made their own signs.

Anti-Obamacare MG_01021.jpg
The counter-protesters carried professionally designed and printed signs and banners.

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The anti-Obamacare protesters were there because they had a stake in health care reform and showed up on their own time. Some even took time off from their jobs to be there. The counter-protesters were there because they were paid to be there.

The anti-Obamacare protesters understood what they were protesting against and what they were for. Some of the counter-protesters didn't even know what the signs and banners they carried said because they didn't speak a word of English.

This clinic [outside which the protest was taking place] is adjacent to Denver's day laborer pickup street, Park Avenue. Being fluent in Spanish, El Marco asked these guys "┬┐hablan ingles?" "casi nada" was the reply from our amigo on the left. I asked him if he could tell me what the signs said. "┬┐Quien sabe?" (who knows?) was all he said to me, with a big grin. I'm kicking myself for not asking them how much they were getting paid to support the grassroots.

The irony of their lack of comprehension of the signs they were holding was heightened by the fact that they were the most elaborate and detailed signs of either group.

This is yet another example of the double-standard being applied to moderates and conservatives.
Continuing on the same subject of health care reform and the resistance by the public to it that's been building, let's look at more reports on activities around the nation. This is a compilation of links from Instapundit and other sources, making them a little easier to find.


In Simsbury, Connecticut a crowd confronted Representative Chris Murphy (D-CT) during one of his 'supermarket town hall meetings', making known their displeasure with Obama's health care reform and their current Senator, Chris Dodd.


In Raleigh, North Carolina Congressman Brad Miller had a number of protestors across the street from his office. The protesters had to resort to the across-from-the-office location because Miller had decided he wasn't going to hold any town hall meetings to discuss and shill for Obamacare.


In Atlanta, Georgia the questioning must have gotten to Representative David Scott (D-GA) when he lost his temper after a constituent asked him a question about health care reform during general purpose town hall meeting.


John Dingell's (D-MI) Health Care Reform town hall meeting didn't go all that well, with attendees deriding his claims that the bill as written would solve health care problems across the board. Anyone that's taken the time to read the bill would know that isn't even close to the truth. As one of the authors of the bill he should know that.


Even the Washington Post is having questions about the health care reform bill, particularly Section 1233, which deals with so-called "end of life" counseling.


Representative Gabrielle Giffords (D-AZ) has been avoiding her own constituents, being a no-show at one of her own events.


In Memphis, Tennessee a town hall meeting hosted by Representative Steve Cohen (D-TN) was less than cordial as approximately 500 attendees loudly debated the health care reform bill with Cohen and each other.


More to follow.

A big tip of the hat to Instapundit for the links I've consolidated here.
If you want to see one view of the financial side of health care reform as being pushed by the Democrats, Arthur Laffer has a breakdown of the costs and why the reform measure won't save a dime. Instead it will cost the American public trillions of dollars and won't provide the health care promised.

Consumers are receiving quality medical care at little direct cost to themselves. This creates runaway costs that have to be addressed. But ill-advised reforms can make things much worse.

An effective cure begins with an accurate diagnosis, which is sorely lacking in most policy circles. The proposals currently on offer fail to address the fundamental driver of health-care costs: the health-care wedge.

The health-care wedge is an economic term that reflects the difference between what health-care costs the specific provider and what the patient actually pays. When health care is subsidized, no one should be surprised that people demand more of it and that the costs to produce it increase. Mr. Obama's health-care plan does nothing to address the gap between the price paid and the price received. Instead, it's like a negative tax: Costs rise and people demand more than they need.

That's been a problem with health insurance from day one. Once it started covering even routine care it drove the price of providing that care through the roof. Even an office visit for a cold, sore throat, or the flu cost many times the actual price of providing the service because of the added paperwork needed for the insurance company and patients started making more frequent visits to their doctors because it wasn't like they believed they were really paying for them. From that point on costs rose many times faster than the rate of inflation. An example from one commenter to Laffer's op-ed piece:

In 1968 an Admiral 23 inch Color TV cost $349 and the Average Hourly Wage in the US was $3.02. A Good TV cost 115 hours of work. In 2009 a Sony 26 inch LCD TV cost $449 and the Average Hourly Wage in the US is $18.41. A Good TV (A vastly superior TV) cost 24 Hours of Work.

A private patient hospital room was typically $72.00/day in 1968 or 23 hours work (average worker). A private patient hospital room today (Per diem expenses) is typically $5,180/day (MEPS) or 281 hours of work.

Has the quality of care increased during that time frame? For the most part, yes. But has the quality increased by a factor of 12 in that time? No way. While the technology available today is far superior to that of 1968, for the most part it costs less than it did back then. And while some of today's technology didn't exist 40-some years ago, it does make care and diagnostics far quicker and less expensive on an actual cost-per-patient basis. Monitoring equipment keeps tabs on a patient without the need to have a nurse or doctor to check the patient, saving the costs of manpower. But once other costs are figured in, those primarily being paperwork for the insurance companies, carrying costs over for the uninsured or under-insured, and CYA approaches to diagnostics by physicians to procure evidence in case they are sued by a patient, it's no surprise health care costs have risen many times the rate of inflation.

While Obama and the Democrats are right that health care must be reformed, their means of doing so will merely make things worse. Instead they should look at what Laffer has suggested and ask their constituents what they think about it. I think they'd be surprised at the response they get.

Expatriate New Englanders

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