Strong Words from Obama on Health Care Reform
From Obama’s AMA speech today in Chicago, via Ben Smith at Politico:
There are countries where a single-payer system may be working. But I believe — and I’ve even taken some flak from members of my own party for this belief — that it is important for us to build on our traditions here in the United States. So, when you hear the naysayers claim that I’m trying to bring about government-run health care, know this — they are not telling the truth.
The strong words don’t stop there. Later, the President says:
… even if we accept all of the economic and moral reasons for providing affordable coverage to all Americans, there is no denying that it will come at a cost — at least in the short run. But it is a cost that will not — I repeat, not — add to our deficits. Health care reform must be and will be deficit neutral in the next decade.
Smith provides the full text of the speech for those who care to read it.
I decline to argue the merits of Obama’s claims in this speech — because I’m woefully unqualified to do so — but I will note that, on purely stylistic grounds, this speech seemed to contain a greater number of definitive statements, and less of Obama’s legendary knack for nuance, than his other recent speeches.
If that’s an accurate observation, it might suggest health care is one subject on which this President will extend only the shortest rope to the “naysayers” before he cuts them off. Such impatience would be consistent with Obama’s expressed view that the moment is ripe but the window for reform is limited, that “this is an historic opportunity we’ve never seen before and may not see again.”
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7 Responses to “Strong Words from Obama on Health Care Reform”
Thanks, Pete. This is not a silly political-gossip subject but something serious, and among the most serious given that the Obama administration is choosing to proceed at this time with an increased federal presence in (incrementalist moves toward federal provision of) health care.
The AMA's stance is of interest here because for years the AMA has shifted leftward to some extent (it's hardly the AMA of the 1950s that would tremble and even point at the Hammer and Sickle when referring to “socialized medicine” or claim a freedom to treat or not to treat people, in fact supporting racism) over the years, possibly being more truly left, perhaps just being beaten down by events. I can say that it is really a concern now with many doctors that they fear losing money. Many doctors are resigned to government health care or even would embrace it because they hate lawsuits and insurance companies, as they have told me and anyone here can ask doctors about themselves. But they fear financially (there is one example I know of where clinics truly lose money with each Medicare patient) and face other hassles with government programs as well. Many doctors right now don't take Medicare or Medicaid patients because of this. Forcing them to do this and be insufficiently paid, or the equivalent in any new federal initiative, is the equivalent of slavery. And something disturbing I've heard about how the new federal expansion of health care in the form of a “public option” will be paid for is in reductions to doctors and hospitals, the very worst thing doctors (and hospitals) should have to anticipate.
Obama can say that a “public option” plan is not a Trojan horse for federal health care for more people, but only technically. It's openly transparent that this is an incrementalist measure for such health care.
“Such impatience” (with opposition) may be said to be childish, but more imortantly, is also restated accurately in so many instances like this as arrogance and conceit by someone elitist or power-hungry, you realize. If impatience is palpable, that's another ominous, sinister sign that the Dems, particularly the farther-left Dems, may be not only ambitious but agitating for “progress.” [gulp]
Everyone who can contribute(?!) to this in Washington is engaged. I had noted on another thread that there was an Indian Health Service story in today's paper here in Detroit (this is the federal health care enterprise by the feds that few pay attention to, though it teaches us some lessons as do Medicare, Medicaid, and the VA about the future for us with federal health care for everyone — money will be a problem, and groups without clout get especially short-changed, and those with poor health without clout face disaster). Just above that (on page 9A) was a story on Sibelius's latest contribution to the set of ideas or proposals, namely a “co-op” scheme. Really, it's not that far removed from what many sloppily and evasively call “single-payer” (WHO'S THE PAYER?). Sibelius advocates providing federal financing, but (she says with a straight face) no federal control. Everyone knows that with federal money (and often without it) comes federal control.
“it is important for us to build on our traditions here in the United States.”
The utility model, a regulated quasi-monopoly, is one approach, at least with clinics and hospitals.
Just a reminder, DLS, as you continue to talk about “federal health care”. Medicare only does one thing, same as insurance companies: assess the claim, send a check. It's no more “federal health care” than it is when a homeowner gets a check under the federal flood insurance program. All the talk about socialized medicine is nothing more than scare tactics and misdirection. Your doctor works for you, whether Blue Cross sends the check or Washington.
Your anecdotal remarks about doctors and clinics not liking Medicare and losing money are just that, anecdotes. The Medicare Policy Assessment Commission MedPAC, actually studied this in exhaustive detail and reported (as a part of the Bush administration, not Obama) that 97% of doctors take new Medicare patients, same as take new private insurance PPO patients. Virtually 100% of hospitals do.
They're free to turn away from the growing numbers of elderly patients, and if they were REALLY losing money on them, they would. Medicare covers the highest risk population better and cheaper than ANY insurance company. Private insurers, even with a much less expensive (younger) risk pool, can't touch the Medicare model, which is why they, and their adherents here, are so willing to lie and fearmonger in order to keep their monopoly.
So, Pete, speaking of just “political messaging” over the health care issue, what was your take on the rumor floating around that Obama is satisfied to get bipartisan support moreso than 100% of his plan.
That likely means no public option and no significant taxing of employer provided benefits.
The AMA's stance is of interest here because for years the AMA has shifted leftward to some extent
More than just to some extent, they've shifted a lot which is a major reason only 19% of practicing physicians belong to it (much of the AMA membership is medical students and residents whose institutions pay their fees). The AMA is hardly the bunch of money-mongers they're painted as. Nancy Neilsen (outgoing president) has been very supportive of universal health care over the past year and I was surprised to see the AMA actually showing some support for practicing physicians. Generally they keel over to whatever Washington wants.
As far as Obama's speech, if he can pull it all off I will publicly kiss his butt on the White House lawn, but the measures he has suggested to improve efficiency just will not give the kind of savings he needs. The budgeting is all smoke and mirrors, and Obama is either misinformed or dishonest.
Health care access is very important and America is the only country in the developed world that has not figured it out. But there is more to reform than access – or should be. Much of the discussion has not been about the real issues of why we have a serious crisis in health care delivery in America. There are many reasons why medical care costs so much but at the top of the list is the high cost of caring for those with complex, chronic illnesses – diseases that tend to last a lifetime such as heart failure, chronic lung disease and diabetes with complications. These occur as the population ages and as we continue with our adverse behaviors such as poor nutrition, obesity, lack of exercise, stress and smoking. Not only are these expensive diseases to treat but our system of care delivery is not well coordinated leading to excess doctor visits, procedures, tests and hospitalizations. A good place to start would be to ensure care coordination for those with chronic disease and to improve our behaviors so that fewer of these illnesses occur into the future.
Health care reform needs to address four interrelated issues. Most of the attention has been on access for those without insurance. But just getting an insurance card to all Americans will not mean good healthcare. Today, we have a system that focuses on disease treatment but not health promotion. We have a system that costs far too much, in large part because care is not well coordinated for those with lifelong complex chronic illnesses [e.g., heart failure, diabetes] such that they end up with unnecessary doctor visits, tests, procedures and even hospitalizations. And we are a nation with behaviors that lead to more life long chronic illness – poor nutrition, over weight, under exercised, stressed and 20% still smoke. Meaningful healthcare reform must address the societal issues with incentives to change, the care coordination issue with incentives to primary care physicians to become care coordinators – real orchestrators rather than interveners and assuring access. And we must have incentives to physicians to spend the time needed to assure real preventive care. Access without attention to meaningful attention to improving quality while reducing costs will only mean more people are getting less than appropriate care. More at http://medicalmegatrends.blogspot.com
The entitlement mentality never ceases to amaze me.
“Medicare covers the highest risk population better and cheaper than any insurance company.” That's because the rest of us are paying for the balance, you dolt. I pay more so you can pay less. The ONLY reason the 65 year old with renal failure gets dialysis (or anything for that matter) is BECAUSE of the private sector supplementing the relatively low Medicare rates. Take a look at the comparative effectiveness research Mr.O snuck into the ARRA (i.e. rationing). You WILL have a bureaucrat decide what care you get. For example, elderly in the UK are turned down for hip replacements because the gov't says they are too fat or too old. With socialized medicine we will all be at the mercy of the government with all its price fixing and audits and tyranny in general. This Ponzi system is a stack of cards on the verge of collapse. We need tort reform, discontinuation of taxpayer paid futile end-of-life care, and illigal immigration enforcement. The only one of these that the O is open to is the rationing, but most likely his idea of futile will be a bit different from yours and mine.
“They're free to turn away from the growing numbers…”
Many doctors are contractually obligated to accept government payers by the hospitals that grant them priveleges; government control = slavery.
BTW, the federal flood insurance program is socialized insurance as well, with taxpayers picking up the tab for most claims. I don't see private companies selling these policies.
You have lived in the Golden Era of entitlements and wealth transfer. Your children and grandchildren will not get that privelege.