Healthcare: Corporate Parties

[dgriffin]

Thanks to a tip on Kim's blog ( poppinsponderings.blogspot.com/ )
I found my way to the following. Not normally a fan of Moyers', I have to say he has this one right, but I don't understand why it's a surprise to anyone.


www.facebook.com/topic.php?uid=2231653698&topic=102135


From Glenn Greenwald's Blog:

Bill Moyers was on Bill Maher's show last night and spoke about the core failures of Democratic Party in the context of both the health care debate and the ongoing escalation in Afghanistan. The whole discussion is really worth watching (at least until HBO intervenes, the entire 30-minute interview can be seen in 3 parts: here, here and here; HBO is re-running the show throughout the weekend on this schedule), but I want to excerpt several key parts, including his very complimentary featuring of this post~(http://tinyurl.com/lrklg2) I wrote on Thursday regarding Democrats:


[On what's really happening in the health care fight]:



MOYERS: I don’t think the problem is the Republicans . . . .The problem is the Democratic Party. This is a party that has told its progressives -- who are the most outspoken champions of health care reform -- to sit down and shut up. That’s what Rahm Emanuel, the Chief of Staff at the White House, in effect told progressives who stood up as a unit in Congress and said: "no public insurance option, no health care reform."

And I think the reason for that is -- in the time since I was there, 40 years ago, the Democratic Part has become like the Republican Party, deeply influenced by corporate money. I think Rahm Emanuel, who is a clever politician, understands that the money for Obama’s re-election will come from the health care industry, from the drug industry, from Wall Street. And so he’s a corporate Democrat who is determined that there won’t be something in this legislation that will turn off these interests. . . .

Money in politics -- you’ve had in the last 30 years, money has flooded politics . .. the Supreme Court saying "money is free speech." It goes back to the efforts in the 19th Century to give corporations the right of personhood -- so if you as a citizen have the right to donate to campaigns, then so do corporations. Money has flowed in such a flood into both parties that the Democratic Party gets a lot of its support from the very interests that -- when the Republicans are in power -- financially support the Republicans.

You really have essentially -- except for the progressives on the left of the Democratic Party – you really have two corporate parties who in their own way and their own time are serving the interests of basically a narrow set of economic interests in the country -- who, as Glenn Greenwald, who is a great analyst and journalist, wrote just this week: these narrow interests seem to win, determine the outcomes, no matter how many Democrats are elected, no matter who has their hands on the levers of powers, these narrow interests determine the outcomes in Washington, even when they have to run roughshod over the interests of ordinary Americans. I’m sad to say that has happened to the Democratic Party.

I’d rather see Barack Obama go down fighting for vigorous strong principled public insurance, than to lose with a [corporate-dominated] bill . . . . the insurers are winning. Everyone already knows the White House has made a deal with the drug industry -- promising not to import cheaper drugs from Canada and Europe – promising not to use the government to negotiate for better prices -- that deal has been cut . . .

There’s this fear that Barack Obama will become the Grover Cleveland of this era – Grover Cleveland was a good man, but he became a conservative Democratic President because he didn’t fight the powerful interests – people say Obama should be FDR – I’d much rather see him be Theodore Roosevelt --– Teddy Roosevelt loved to fight – … I think if Obama fought instead of really finessed it so much . . . I think it would change the atmosphere.

[gski]

Dave,

I think that money and politics have show their influence and corruption to their highest in the past several months, and even years.

It's almost gotten to the point of elections being a mere formality for politicians. Show up and get elected, don't necessarily represent the people who elected you, rather what's in it for them and their leaders.

The point is highly illustrated in health care. We've heard for years that Medicare & Medicaid are wrought with fraud. We've heard for years about the frivolous lawsuits, and we see almost daily the tv ads for class action lawsuits.

What's being done about it? Nothing. To me it's equivalent to your dog making messes in your neighbors yard. Do you shoot the dog? Normally no, you put him on a leash or put up a fence so he can't do that. You solve the problem.

Our government isn't doing that now. It's creating a whole set of new problems, instead of addressing issues that got us here in the first place, while expanding it control.

To further the point of, what to me is the lunacy of the whole plan, we have been told that the new health care option won't increase costs and won't lead to health care rationing.

Again, go back to basics. If you have a loaf of bread for 10 people and you now take that same loaf for 20, 40, 80, 100, 1000, everyone gets less. How do you add millions of people to a health care system without adding to it's infrastructure, Dr's, nurses, & hospitals and say that you will have the same health care without rationing or severe delays.

That's just common sense. The answer, show people that you are fixing what's in place, show them the results. Once you've done that, then they would be receptive to adding to it or changing it.

The problem with those in power right now is a small one that they forgot. If you tick off the American people and enough of them get upset about it they will unite. Everyone gets angry when the majority are saying no and those in power go ahead and do it anyway not representing those who voted them in power.

Obama's best bet is to do what Bill Clinton didn't do. Bill should have admitted what he did was wrong, he would have one respect by doing so. Obama would win respect and start to win people back if he said, "folks, I hear what you are saying about health care and we are going to go back to the drawing table, fix what's in place first and then come back with something that the majority can agree on".

[dgriffin]

Gski, I agree with you, but I can't help myself from continuing to be hopeful .. although wishful might be a better word ... as in wishful thinking.

Your "loaves of bread" example leaves out the possibility that the price of bread could go down, admittedly a second cousin to the Loaves and Fishes multiplying to fill the needs.

I'd say the idea behind socializing medicine ... an unmentionable term for those promoting it ... is that EFFICIENCY will lower the costs and enable more services to be provided to more people. Efficiency and maybe a little browbeating of the providers and reining in of insurance company profits. Now that's a theoretical argument that would seem to have some promise, certainly more so than the previous experiment of HMO's, where preventative health maintenance was supposed to make us all so healthy that we didn't need to seek medical services. (And which has since been shown to be a pipe dream.)

But it's theoretically possible to provide more for less if someone is making a hell of a lot less money in the scheme. And health care on a national scale ... even our convoluted system of payers, copayers, tiered pricing and you-never-know-what-the-hell-you'll-get-billed kind of mess ... should be able to be analyzed such that all those smart people we've been training in our universities can present to us financial cases of what arithmetic might work and what won't. You'd think.

But you've hit the nail on the head. No one on our Open Mic national stage wants to present the American public with worthwhile real information. They all have their own agenda and therefore present only what abets their interests.

Which is why the American public is pissed off. Which is why the politicians are beginning to back off. Which is why not much will change in the near future.

I think you're right about what Obama should do. A national hero could be made of this situation, if someone would step forward and suggest what you said. Back off and move it forward a step at a time with reasonable, but concrete goals. That person could be YOU, gski, except for the fact that you don't have a spare $100 million to buy your way into the national spotlight. But on the off chance you do, I'll hold your coat.

Where is Ralph Nader?

[dgriffin]

Answering my own question ... it's more efficient that way ....Nader was Single Payer in February of '08 and is probably still that way.....



The Wall Street Journal



Nader on Health Care: Single Payer is the Way to Go

February 25, 2008


"For all of their talk about universal health care, Barack Obama and Hillary Clinton look pretty conservative on the issue, compared with yes-he’s-running-again-for-president Ralph Nader.

In announcing his 2008 bid for the White House on “Meet the Press” yesterday, Nader said: “All, all the candidates — McCain, Obama and Clinton — are against single-payer health insurance, full Medicare for all. I’m for it, as well as millions of Americans and 59% of physicians in a forthcoming poll this April.”

Nader’s campaign Web site is scant on details so far, but he’s talked plenty about the issue. In an interview with “Democracy Now!” last July, for instance, Nader said if he had it his way, health care in the U.S. would “look like full Medicare for everybody, whereby the government is the payer.”

He added, “In Western countries, the outcomes in terms of infant mortality, in terms of life expectancy, in terms of lower levels of anxiety — they don’t have to worry about losing their life savings for a tragic illness — are all better than the United States system.” His single-payer idea contrasts with Clinton’s and Obama’s plans, which wouldn’t be funded solely by the government."


CONTINUED AT:


blogs.wsj.com/health/2008/02/25/nader-on-health-care-single-payer-is-the-way-to-go/

[gski]

Dave,

I guess that the whole problem with every bit of the Health care BS is that the system is so far entrenched that how can you change it without blowing the whole thing up?

This reminds me of a medical condition, that there's no real cure for.

If you cut back on reimbursements, you'll get less dr's. Less dr's ends up meaning less nurses, etc, etc. So you can't do that, unless you "nationalize" the whole thing. That would tick off a ton of people.

When you involve the competition clause, private vs public, you're simply not on a level playing field and you are now saying that government would be more efficient. That would be a change for sure, and I believe a first!

Now you move to the "mandatory" phase. Everyone has to have healthcare. Ummm,..what about those people who can afford healthcare but "choose" not to? What makes you think you can force them to pay for it?

Now comes a question that I'd love to hear the politician's answer. "IF" this whole thing went through and Dr's cannot do "all" the "normal" tests that they would, and admittedly, some are for CYA purposes, what happens when someone dies because of this fact?

Do the Dr's still get sued, or do they get to say, "sorry, sue your government", they said I can't run that test, which I would normally have done and found the problem?

Maybe we should ask this question or throw it out to the malpractice lawyers and let them run with it. They could be losing a ton of business!

[chris]

Well Utica made our Sunday paper today with this article from Arcuri. Read on.........

www.democratandchronicle.com/article/20090830/NEWS01/908300336/1003/NEWS01/Arcuri-amazed-at-health-care-beliefs

[dgriffin]

I think I'd first attack the health care problem in the US by defining it. Exactly what is the problem? Some people can't afford health care? Put 'em on Medicaid. Expensive, yes. But probably cheaper in the long run, as long as we also tinker with other parts of the system.

The second thing I'd do is ensure there are more doctors. I'm guessing we could easily double the current number of doctors in the US (aside from importing them) if we lowered the entrance requirements for Medical schools and simultaneously built more schools. (THAT would be a worthwhile investment by the government.) Is there any reason why your physician needs to have had a 3.85 GPI coming out of college compared to a 3.5 or 6? I doubt it.

After Sputnik launched in 1957, the media went crazy with fear about the technology gap between Russia and the US. Eisenhower knew this was BS, but the government was politically forced to spend vast amounts of money in education grants to train extra engineers and technicians. (Good thing we did, too, because it helped form new industries. Kennedy saw this effect and sponsored the Apollo Project. Same results.) The high school 4 year average for admittance to engineering college probably dropped 5%, in some cases 10 %. I was part of this wave. It yielded some of the best technical people America has ever produced.

But had there been an union of engineers (like the IEEE) as strong as the AMA and other medical organizations and companies, one wonders what would have happened. We can easily train more doctors and physician assistants and flood the market with them such that fees will come down to a reasonable level. I don't care how much it costs to be in business as a doctor, it's absolutely crazy that a GP charges $200 for a five minute appointment these days. Or that a surgeon gets thousands to snip out a gall bladder. Yes, I know about malpractice insurance, etc. But I go to a practice with 3 doctors. The office has a staff of at least ten clerks, plus nurse assistants. That's crazy.

[dgriffin]

Chis, Arcuri's comments are old stuff. He likes to talk about things he hears from people who don't read the news so that he can sound smart. You'll notice he doesn't attack the questions that are not so easy to answer. Like costs and rationing, etc. Instead, Arcuri is still in the "death panel" stage where he is evidently comfortable.

[gski]

Dave,

I think you've got some good points, however I don't know if I'd go more toward Medicaid. I might go more toward increasing the State Blue Cross programs for lower income families. This way people actually contribute toward it.

Increasing the Dr's, no question. That brings into question competition and you're right, we really don't have much in the way of Dr's competing for their services. This weeks special, hmmm, maybe.

You bring up a good point about office staff. Way back in my prior years I used to train dr's & their staff on computized medical billing systems. Oh boy! In some cases, dumb as a rock comes to mind.

Anyway, the issue ends up being, managing the chaos of a dr's office. Double and triple booking, yup, we all know that's why we wait. You've got an office manager, a nurse or two, and at least a medical assistant or two and someone who handles the billing. That's six people right there for an office, maybe 5. Then add the cost of the office, utilities, salaries of each person, insurances, incuding malpractice and there's your $200. Take away your malpractice insurance and the cost would drop substantially.

Now let's throw one more little thing into the mix. Medicaid. BCBS might pay we'll say $150 for the visit. You get the rest of that. Medicaid. Same $200, they approve $90 and pay $72, 80% of what's approved. The Dr, now get's to bill the difference $18 to another insurance, like medicare. They pay 80% of the $18, or $14.4. Total paid on that $200 charge $86.40. The figures aren't exact, what Medicaid would pay, but they are close. They don't come near what's paid by a non medicaid insurance company. Part of the issue. So who makes up the difference? We do.

If they participate in some insurance companies, they have accept what's paid and not bill for the remaining amount. I know of some Dr's that used to tell medicaid people who came for flu shots to go to a clinic, because Medicaid didn't pay for the Nurse to give the shot and at that time, wasn't paying for the full cost of the serum.

You are right though, the costs are ungodly. Thank the lawsuits for a good portion of it and government mandates for another. When they make electronic patient records mandatory, for those who aren't already, the Dr's will eat that cost too.

I don't want to sound like I'm totally defending the Dr's , however, I had my eyes opened many years ago, first hand. It's crazy, especially the debt that they come out of college with.

Unfortunately, it's a vicious circle, that has to slow down. I know where I'd like it to start, I just don't see the government biting the hand that feeds them, and they don't believe that hand belongs to us.

[dgriffin]

Yup, it's complicated, and no one person or institution deserves the blame.

I had a stress test some years ago at a local hospital. The monitoring physician did two of us at once by sliding back the curtain and observing both (we couldn't see each other.) I'll have to make up these figures, but you will know I'm not proportionately not too far off. The heart specialist charged $750. My insurance company paid him somewhere around $125. What bothered me was that had I no insurance, I'm sure he would have tried to collect $750 from me. Like many people without insurance, however, I would have certainly negotiated.

Hell, even with insurance, I have negotiated. I got so pissed off at the same local hospital when they charged me an ungodly fee for a diagnostic test, I told them I wasn't paying my part after insurance, some $400. I got a quote from another non-hospital diagnostic clinic for half and waved that in the face of the hospital billing department. I finally told them they could hound me all the way to hell, but I wasn't going to give them a cent until the were willing to negotiate. That worked, and I wound up paying them $250.

[chris]

Doctors and nurses are supposed to be helping the sick. Instead they have to spend most of their time filling out paper work required by "government" . Maybe government should stay out of our way and let us do our jobs which is a hell of a lot better than they can do and cheaper. Let them create a care package for the uninsured and leave us alone.

I have been fortunate enough so far (knock on wood) to be healthy but as my mom's POA I am seeing bills come across my eyes that are making my eyes pop. One has to scrutinize very carefully for all these services that seem to come out of no where. Just cause you recieve a bill does not mean it is correct or you actually should be paying it. Many older folks do so unknowingly.