RSS Feed for This PostCurrent Article

Talking Turkey Over Health Care Reform

The Senate is back in session this week, and will begin its work on hammering out the new bill they put forth before the Thanksgiving recess on Health Care Reform. Here is a reminder of Senator Reid’s presentation of the new bill:

Who wants to place bets on whether or not Charles Krauthammer will have to eat his hat given the dollars Reid claims will be saved by this particular Health Care Reform bill? I will go out on a limb and say I think Dr. Krauthammer’s hat is safe.

What, then, is to be done? Well, Dr. Krauthammer thinks both bills should be killed, and we need to start all over again:

The United States has the best health care in the world — but because of its inefficiencies, also the most expensive. The fundamental problem with the 2,074-page Senate health-care bill (as with its 2,014-page House counterpart) is that it wildly compounds the complexity by adding hundreds of new provisions, regulations, mandates, committees and other arbitrary bureaucratic inventions.

Worse, they are packed into a monstrous package without any regard to each other. The only thing linking these changes — such as the 118 new boards, commissions and programs — is political expediency. Each must be able to garner just enough votes to pass. There is not even a pretense of a unifying vision or conceptual harmony.

The result is an overregulated, overbureaucratized system of surpassing arbitrariness and inefficiency. Throw a dart at the Senate tome:

– You’ll find mandates with financial penalties — the amounts picked out of a hat.

– You’ll find insurance companies (who live and die by their actuarial skills) told exactly what weight to give risk factors, such as age. Currently insurance premiums for 20-somethings are about one-sixth the premiums for 60-somethings. The House bill dictates the young shall now pay at minimum one-half; the Senate bill, one-third — numbers picked out of a hat.

– You’ll find sliding scales for health-insurance subsidies — percentages picked out of a hat — that will radically raise marginal income tax rates for middle- class recipients, among other crazy unintended consequences.

Okay, I already have a headache just reading this. No wonder Krauthammer reaches this conclusion:

The bill is irredeemable. It should not only be defeated. It should be immolated, its ashes scattered over the Senate swimming pool.

Then do health care the right way — one reform at a time, each simple and simplifying, aimed at reducing complexity, arbitrariness and inefficiency.

First, tort reform. This is money — the low-end estimate is about half a trillion per decade — wasted in two ways. Part is simply hemorrhaged into the legal system to benefit a few jackpot lawsuit winners and an army of extravagantly rich malpractice lawyers such as John Edwards.

The rest is wasted within the medical system in the millions of unnecessary tests, procedures and referrals undertaken solely to fend off lawsuits — resources wasted on patients who don’t need them and which could be redirected to the uninsured who really do.

In the 4,000-plus pages of the two bills, there is no tort reform. Indeed, the House bill actually penalizes states that dare “limit attorneys’ fees or impose caps on damages.” Why? Because, as Howard Dean has openly admitted, Democrats don’t want “to take on the trial lawyers.” What he didn’t say — he didn’t need to — is that they give millions to the Democrats for precisely this kind of protection.

Tort reform has been a common refrain for what is glaringly absent from this Health Care Reform bill, and one component conspicuously absent. But that’s not the only problem:

Second, even more simple and simplifying, abolish the prohibition against buying health insurance across state lines.

Some states have very few health insurers. Rates are high. So why not allow interstate competition? After all, you can buy oranges across state lines. If you couldn’t, oranges would be extremely expensive in Wisconsin, especially in winter.

And the answer to the resulting high Wisconsin orange prices wouldn’t be the establishment of a public option — a federally run orange-growing company in Wisconsin — to introduce “competition.” It would be to allow Wisconsin residents to buy Florida oranges.

But neither bill lifts the prohibition on interstate competition for health insurance. Because this would obviate the need — the excuse — for the public option, which the left wing of the Democratic Party sees (correctly) as the royal road to fully socialized medicine.

That’s an interesting take on it. And still more:

Third, tax employer-provided health insurance. This is an accrued inefficiency of 65 years, an accident of World War II wage controls. It creates a $250 billion annual loss of federal revenues — the largest tax break for individuals in the entire federal budget.

This reform is the most difficult to enact, for two reasons. The unions oppose it. And the Obama campaign savaged the idea when John McCain proposed it during last year’s election.

Insuring the uninsured is a moral imperative. The problem is that the Democrats have chosen the worst possible method — a $1 trillion new entitlement of stupefying arbitrariness and inefficiency.

The better choice is targeted measures that attack the inefficiencies of the current system one by one — tort reform, interstate purchasing and taxing employee benefits. It would take 20 pages to write such a bill, not 2,000 — and provide the funds to cover the uninsured without wrecking both U.S. health care and the U.S. Treasury. letters@charleskrauthammer.com)

I tend to agree with Krauthammer – I think we need to deep-six these two bills and start over. Additionally, I do not want anything in these bills that has NOTHING to do with Health Care Reform. No pork, no bribes, nothing that is not strictly related to issues of health care reform. But that’s just me. At the very least, both houses need to start over, and do it right this time, not throwing together whatever they can in the shortest amount of time possible. This is a serious issue, and merits serious consideration, not political expediency.

If Congress does THAT, starts completely over, leaves out the pork, does what’s best for American citizens and not their respective political parties, I’ll eat MY hat…

  • http://www.BullShit.com Osellingbullshit

    EXCELLENT, Well said Amy. Kill the bills.

  • cat

    Krauthammer called a liar on the White House website:

    http://www.whitehouse.gov/blog/2009/11/27/reality-check-column-ignores-facts-about-health-reform

    they fear him.
    GOOD.

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Thanks, O!

    cat, that is interesting indeed. Yeah, if they’re calling him a liar, they are sure paying attention to what he says, right? Hmm – I take that to mean we should, too! :-)

  • http://www.noquarterusa.net/blog/2009/11/27/what-i-now-love-about-the-holidays-thanks-to-the-crobonomy/ Silence Dogood

    Oh gee, that paragon of virtue, the Ministry of Propaganda blog over at the Whitehouse — there’s a source we can trust! ;)

  • cat

    ok, to be fair:

    they said his article was “wholly inaccurate”

    and then they went on to um, make s*hit up…

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    ROTFLMAO – thanks for the correction!

  • Kim

    Another great post Amy! I think that until the cost of services is seriously addressed, nothing is going to change. Insurance premiums cost so much, because health services cost so much.

    I think we should be able to cross state lines to buy health insurance. As far as tort reform goes, it is a double edged sword for me. On one hand, I can agree that there are frivilous lawsuits, but on the other, I know that there are a lot of careless doctors and medical institutions that do a lot of damage. Putting a cap on awards sounds good to many, but I doubt that if they lost a limb or had their lives ruined by a “bad” doctor that they would feel that way. Is a life worth only $250,000, which is the number that has been thrown around for the cap on jury awards.

    I would like everyone in this country to have health coverage, but I don’t want any part of what Obama and this Congress is offering. I agree with Krauthammer…scrap the bills.

  • Georgia

    Great Post Rev Amy. I’m nominating you for common sense czar!

  • I’m a Linda too

    OH! Don’t get me started. I will be kind and keep my mouth shut. I just got off the phone with another Democrat, Richardsons versions of price fixing / negotiating health insurance and I was on the verge of crying.

    Why am I paying thousands of dollars when my insurance isn’t’ even kicking in unless I go to the Doctor 4 times in a year, because they have such high deductibles and they deduct the amount of your higher copayment from the deductible so it takes forever to reach that high deductible for a friggin hmo? OMG

    ok…I’m doing it….I’m shutting up and will go cry in a corner.

  • foxx

    I agree the whole set of bills should be defeated. I dearly hope they are and we go back to the drawing board.

    I do not want my taxes going to subsidize insurance companies, which is what these bills essentially are about. This is another version of the bank bailouts. We don’t need insurance companies, they serve no useful function, they are a drain on our health care dollars.

    What we need is a national health care system like all other industrialized countries (and others like Mexico) have.

    I agree with Kim about “tort reform.” The courts are the only way to control malpractice. Professional oganizations are useless. Horrific malpractice stories are often in the news. Things would be much worse if doctors knew they could get away with it. Yes I know there are abuses in the system, I hope we can fix them, but not at the expense of the right to sue for effective damages.

  • mountainaires

    We don’t need no stinkin’ “tort reform.”

    Who in their right mind would actually support the ONE right you have to protect yourself against medical malpractice? Or do you honestly THINK that $250,000 punitive is the sum total of the worth of your life? I can assure you: No doctor would settle for such a paltry sum if he or she were to sue another medical professional for medical malpractice. So, why would YOU settle for that?

    We don’t need “tort reform.”

    We need INSURANCE REFORM. We need to pass 5 straightforward laws stipulating that (1) no insurance company can deny based on pre-existing conditions and that (2) no insurance company can deny coverage based on any condition; and we need to stipulate that (3) no insurance company can cap lifetime coverage for any patient. And, (4) eliminate the anti-trust exemption across state lines for insurance providers.

    That’s it. That’s what we need. At this point in time, that is ALL we need, and certainly all we can afford. Those who cannot afford to get coverage like the rest of us, but WANT it, should be allowed to (5) pay in to medicare. That’s $100 a month out of your social security benefits by the way, that is the standard cost for medicare.

    All the rest is called a SCAM.

    They Aren’t Really This Stupid, Are They?

    Karl Denninger at The Market Ticker:

    There is only thing worse than being stupid – it is admitting that you’re stupid by putting a bankrupt and unworkable “policy” in front of a bunch of professionals who have the acumen to analyze what you’re up to, tell you that you’re nuts, and then act on it to profit while grinding the banks and indeed all of America into dust - but you stick to it as “policy”, even though those who are smarter than you are have told you point-blank that it won’t and in fact can’t work.

    Thank you Barack and Turbo Timmy – you own it, this is your policy, this is your legacy…….

    ……and this will be your political obituary.

    http://market-ticker.denninger.net/

  • http://www.hillaryorbust.com Hillary or Bust

    It really ticks me off that my taxpayer money is going to support that partisan propaganda website known as “WhiteHouse.gov.”

  • http://votingfemale.wordpress.com/2009/11/30/sarah-palin-surge-now-lead-in-the-polls-so-says-washington-post/ Sarah Palin Surge; now lead in the polls, so says Washington Post « VotingFemale Speaks!

    [...] Talking Turkey Over Health Care Reform [...]

  • J.J. (The P.U.M.A.)

    We very much need health care reform. But, we will likely not get anything that makes things better because of the far-left ideology of Congress and the incompetence of the guy at 1600 Pennsylvania.

    This bill should have been constructed from the political center out, rather than from the left. What we have, especially in the House version, is a total dis-connect between ideology and the laws of economics.

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Thanks so much, Kim – I appreciate that!

    And I do understand abt tort reform being a “double edged sword” (see comment below). The short of it is, reform is not the same as removal, and I agree, it is an important tool for patients to have. It is how it is abused by too many people, thus inflating the costs of medical malpractice ins., thus inflating OUR costs, that’s the problem…

    Georgia, you are too funny – thanks! :-)

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Tort reform isn’t the same thing as abolishing Medical Malpractice suits. I don’t think ANYONE is calling for that, certainly not me. I have experienced my own medical malpractice that almost cost me my life (and would have had I not found a decent doctor).

    I have heard Krauthammer expound on tort reform a good bit, and his point is that FRIVOLOUS, not sound, but frivolous lawsuits drive up the cost of medical malpractice ins. to enormous heights. I can’t remember who it was talking abt the states in which doctors review suits to see if there is cause for them to move forward or not, but in those states, the costs are much lower (if I recall correctly – any doctors/attorneys out there who know, please share).

    In addition to the insurance reform which you list above is medical malpractice ins. too. Doctors have to pass along those costs – just like any other goods.

    So, just to be clear – I agree that to be able to bring a medical malpractice lawsuit is an important tool for our own well being, but there has to be a way to minimize the number of frivolous cases.

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    I know exactly what you means, IALT, and I am sorry this is making you go cry in a corner. You know we’re here for you!!

    I can relate abt the monies paid out and the high deductible. I just found out that the injection my ortho wants to do in an attempt to prolong my getting a total knee replacement in my right knee (both knees have to be replaced – the partial I got at the beginning of the year hasn’t helped) is NOT covered by my ins. It costs over $800 for one injection.

    My ins. provider will change in Jan., but no telling if they’ll cover it, either…

    Anyway – all of that is to say, I completely understand.

  • Kim

    I’ll second that!

  • steve1

    REFORM, yes, but what is coming down the pike is health care for the rich! Than there will be one for the others…you can kiss your policy good-bye!!

  • steve1

    The Repugs….are no better????????

  • steve1

    HILLARY CLINTON, 2012!!!!!!

  • http://www.noquarterusa.net/blog/2009/11/27/what-i-now-love-about-the-holidays-thanks-to-the-crobonomy/ Silence Dogood

    But its the will of the people(?) he was elected(?)! Oops sorry, wrong universe. :D

  • I’m a Linda too

    For me, my misery does n o t like company. :) I’m so sorry for you too. I’m sorry you have to go through this. Dang. Please ask what this injection is supposed to do and it’s success rate. One time? etc, before you do it.

    Hubby found out last week that he has permanent nerve damage from high eye pressure caused by steriod drops in his eye.

    Oh yes, the same steriod drops they give pateients who do cataract or lasiks surgery. My hubby had a cornea transplant and the Doc did not tell us he would have to take steriod drops every day forever. Since then, we found other doctors say “should only be a couple years”, but the Doctor got upset when we said we were never told this, he said “it’s no big deal, it’s a tiny amount that goes right to the eye”. Then, after he started losing his vision, we found out…that tiny inconsequential drop causes cataracts in 30 pct of the pateients. So now hubby had to lose his lense, opening up the cornea he just was healing from transplanted. Now we find out, it also caused permanent nerve damage to his retina and he has an area he can’t see from.

    Call your new insurance and ask them what they cover. Hubby’s telling me they aren’t letting us switch insurance…if even on 1 year anniversary. !@#$%^&*#$@!!!

  • I’m a Linda too

    And…your post didn’t make me cry…the jerks did. Your post just came up right after getting off the phone with the jerks and it’s been peaking.

  • b mathews

    since this HC debacle will affect everyone in this country, dont you think it should be debated and voted on by the public?.

  • http://www.BullShit.com Osellingbullshit

    Obama said being president is hard….. GW said being president was hard work.

  • kgirl1028

    Sorry to Hijack the post, but i just read on AOL that everybodies favorite first daughter is engaged. Chelsea Clinton is no engaged to her long time boyfriend Marc Mezvinsky

  • http://noquarter foxyladi14

    congratulations to the happy couple

  • tek

    Notice that woman from MO came in and tried to move Dick Durbin over behind Reid but he refused to budge–determined to have his mug in the spotlight! He’s up for re-election. Some guy named Hoffman is challenging him. I’m campaigning for that guy no matter what his views are. Durbin is Minority Whip; if we could get a new guy he’s only be a freshman senator.

  • jwrjr

    Their attempted insults are the best verification that Krauthammer could hope for.

  • tek

    RRRA: I’m so tired of hearing that phrase–frivolous cases. Orwellian Doublespeak. Anyone in law knows that “frivolous cases” never see a day in the courtroom. That’s what briefs are all about. Nowadays, judges are so swamped with work, if they can’t identify a clear cause of action in the first two pages of a brief, it goes directly into the trash. I’ve been in legal writing classes where this subject is covered. You don’t get a case into court if you don’t have a bona fide cause of action.

    Spectacular cases have been twisted by the press into appearing frivolous, it’s not true.

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    I got that it was the ins. jerks who made you cry, and understandably. Your poor husband!! That is terrible that he is having to go through so much, especially since he is still healing from the transplant.

    And the permanent nerve damage – holy cow (I’m using that in lieu of what words I could use). Just breaks my heart for your husband, and you!

    I’m just shaking my head at not being able to switch ins., either. Sheesh.

    Wow, IALT, no wonder you wanted to go to a corner and cry!

    Thanks – I appreciate that.

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    I am not sure one can equate a writing class with actually being an attorney, but I hear what you are saying abt the term, though frivolous litigation is a realty – it happens. Whether it makes it to court or not is a different matter. To say that the only ones that APPEAR frivolous are the result of media hype seems to be a generality.

    I think I got us side tracked on this, though. Krauthammer is talking abt the cost of additional tests and procedures required in order to stave off potential medical malpractice suits, if I am understanding him correctly.

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Yes, indeed Chelsea is. I’ve been thinking abt that today, what a lovely young woman she has grown up to be, the loving, even adoring look on her face when her mom was talking, and how very, very lucky her fiance is that she said yes. :-)

  • Sassy

    There are reports that the other reluctant democrats are upping their negotiated vote prices since Landrieu scored big. Instead of “pay as you go”, it’s now payola.
    Once the public figures out how much this turkey is going to gobble up, it will be too late!
    When will the republicans have enough votes in Congress to revise or revoke it?

  • Clara

    It is very difficult for a lawyer to agree to take a “frivolous lawsuit”. If it is frivolous, or unjustified, then it will never go anywhere and the lawyer will lose money on the case. He/she has to front lots of money to properly conduct a malpractice case and if its not going to return a big enough verdict or settlement, they may not take even a justifiable malpractice case.

    Malpractice insurance companies often take the most expensive way out of the situation. Rather than let a doctor settle, for example, they will insist on taking it to trial. That is one part of this practice that needs to be heavily monitored and somehow changed.

    As a healthcare expert witness at one time, I hate to see damages capped because there truly are lifelong, serious damages that require money to deliver years of care. But there must be some way to improve the education of nurses (I can say that) and to strengthen peer review among docs.

  • lorac

    RRRA – is it synovisc (kind of a lubricant)?

    If so, I think they do it once a week for three weeks, and if it’s helpful, you can repeat it every six months. I understand that most people don’t feel the benefit until after the 3rd injection of the series (the first injection is a small amount, the second a larger amount, and the third the largest). If it works, it kind of feels like a pad has miraculously been inserted into your knee, providing relief. But it doesn’t last…. hence the periodic repeat series…

  • Jackarooty

    Hi Amy,
    I find it so interesting that you are agreeing more and more with Dr. Krauthammer as time goes on. I find him brilliant and fascinating. Like you I am agreeing with him more than I don’t.

    This article was in the NYT on 11/29/09 and I posted it on my fb page. You’ll appreciate it!

    The lack of confidence in government has turned many older voters rightward. Younger voters have not followed. But even they will want results eventually.

    http://www.nytimes.com/2009/11/30/opinion/30douthat.html?_r=1

  • ziggy

    They didn’t call him a liar. They said the information in his editorial was “totally inaccurate”. That’s very different matter from calling someone a liar.

    The White House page cites specific sections of the pending bill. It provides a link to the document. It also provides a link to the editorial.

    Apparently they aren’t afraid of people reading the editorial, comparing what’s said there with what’s actually in the bill, and deciding for themselves how accurate Mr. Krauthammer’s statements are.

  • http://www.noquarterusa.net/blog/2009/11/27/what-i-now-love-about-the-holidays-thanks-to-the-crobonomy/ Silence Dogood

    They didn’t call him a liar. They said the information in his editorial was “totally inaccurate”. That’s very different matter from calling someone a liar.

    Perhaps if one is slicing an apple of truth into slices of ambiguity that is so.

    “Totally inaccurate” is arguably just the polite and lawyerly way of calling someone a liar.

    Please excuse some of us and our more guttural at times ways of expressing our heartfelt views. It should be noted someone’s way of expressing does not necessarily change the core truth of a matter, even if the expression is distasteful or not fit for a courtroom.

    Ironically, the court of American public opinion is far from behaving like a courtroom at all! :D

  • Docelder

    No, most cases never make it to court because it is cheaper to pay them out and settle them than pay the legal fees to push them through the court system. Doctors are out of control once the suit is filed and lawyers take over. It doesn’t matter whether they actually did anything wrong or not. Bean counters determine the outcomes. There could be caps, but what I think is to require attorneys to be bonded and if they lose their bond will pay the defense fees. This would distribute the cost of trying these cases somewhat off the doctors insurers and would let the insurers try the cases they could win without worrying about the cost of doing so. Also, bad attorneys would quickly lose their bonds and would be forced away from filing future suits. They could still practice other kinds of law, just not file tort cases if they can’t get for example a 1M recovery bond. They make doctors keep malpractice, and drivers keep liability insurance. Soon we will face jail time for not having health insurance. Can’t attorneys be just as responsible as the rest of us?

  • Doc99

    Right, Rev. The big money is in “Defensive Medicine,” ordering tests, procedures, consults and office visits whose intent is more to bolster the chart for potential litigation. Less time is spent with the patient while more time is spent with the chart to enhance documentation at the expense of patient care. It’s a sad state of affairs to be sure.

  • Doc99

    More subterfuge from Harry Reid

    The Senate moved forward yesterday on debate of H.R. 3590, to amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes.

    You read that right.

    The bill being used as the shell for Senate Majority Leader Harry Reid’s (D-Nev.) first attempt at a government takeover of health care is in the form of H.R. 3590, an unrelated tax bill.

  • Surfered

    Of course, Mr. Krauthammer also repeatedly wrote in his columns that Saddam Hussein would give nuclear weapons he did not have to terrorists he did not have a collaborative relationship with. So, he’s made some pretty big mistakes before. Hopefully, no one will die unecessarily this time.

  • http://www.justtome.com/talking-turkey-over-health-care-reform-no-quarter/ Talking Turkey Over Health Care Reform : NO QUARTER Just To Me

    [...] is the original post:  Talking Turkey Over Health Care Reform : NO QUARTER By admin | category: georgia malpractice medical | tags: costs, inflating-the-costs, [...]

blog comments powered by Disqus