The more one examines the health care references in Barack Obama’s recent victory speech the more ridiculous they seem, a point not lost on Michael Graham of the Boston Herald:
For sheer entertainment value, few things can beat South Side Obama, the High Priest of Rezko Politics, offering himself as the new Moses in the land of free medical care manna from heaven.
But surely Obama didn’t promise anything of the kind … did he? Actually, he came pretty close:
I am absolutely certain that, generations from now, we will be able to look back and tell our children that this was the moment when we began to provide care for the sick …
Graham is one of the few commentators to pick up on how insulting that statement is to the people who actually take care of patients every day:
Take Obama’s claim that we’re finally going to “provide care for the sick.� Beyond the insult to every American medical professional already hard at work, there’s a price to be paid for this fantasy.
And there is indeed an opportunity cost to be considered. Although Graham’s notion of a ”catastrophic coverage” mandate is naïve, his basic point is valid. We need effective action, not empty slogans.
Obama’s approach to health reform involves windy bromides and a plan whose main feature is yet another sclerotic bureaucracy. If we elect him President, he will transform a fixable problem into an unmitigated disaster.
Comments 6
If you believe it is fixable what is the fix?Will everyone have health care at a cost they can afford?
Posted 11 Jun 2008 at 12:17 pm ¶No. The fix is taking responsibility for your health. This will lower the overall utilization and open up more resources for those that have conditions that are unrelated to lifestyle.
Posted 11 Jun 2008 at 3:55 pm ¶“Will everyone have health care at a cost they can afford?”
Herein lies the rub:
Define “health care.”
Posted 11 Jun 2008 at 4:18 pm ¶You are getting close to the mark.
Posted 20 Jun 2008 at 10:00 pm ¶I’m a cancer surgeon.
The problem is basically this: we have a collection of systems (Medicare, Medicaid, private insurance, SCHIP) which has somebody else paying your tab for healthcare.
You have no stake, other than the premium you pay, into how this system works. You have no incentive to lose weight, excercise, and stop smoking (the only prevention you can practice).
Furthermore, these “third parties” have grown into multi-billion dollar industries that have all driven up the cost of that premium artificially, claiming that “costs are rising” for delivering care. I can tell you, MD’s in the 80’s got about $5k for doing radical cancer surgery. Today I get about $1900-2300 for the case and 90days of perioperative/postoperative care. This has all come about through denials/downcoding of my “claim” (not bill) for reimbursement for my services. I, in essence, and forced to take whatever they pay me and I can’t bill you for the rising cost of my overhead. My paycheck has decreased yearly since 2000.
Yet they tell you that I and my colleagues are pumping up the cost of medicine.
Here’s what nobody is saying: smart guys are currently NOT choosing this profession.
You are all screwed. It’s over.
In exchange, you are getting technicians more interested in time off than breaking their backs being good at medicine.
Mark my words. All this BS about “quality assurance” only works for manufacturing– not for professional excellence.
‘You have no stake, other than the premium you pay, into how this system works.’
Single payer/universal care would introduce more accountability by making healthcare a collective political issue. It’s also a myth that US citizens use health services more because the costs are hidden - in fact they visit less on everage than most other major western countries.
‘You have no incentive to lose weight, excercise, and stop smoking (the only prevention you can practice).’
Well, diet is a big factor. But health promotion is a complex society wide issue - it’s not just about acute heath care costs.
‘I can tell you, MD’s in the 80’s got about $5k for doing radical cancer surgery. Today I get about $1900-2300 for the case and 90days of perioperative/postoperative care.’
The main difference between US healthcare and the other OECD countries is the sheer direct cost of your hospitals and doctors. Paying yourselves a decent but not huge salary and not charging for piece work would be a good start, as would wondering why some of your top administrators get salaries in the millions of dollars compared with say a maximum of about $300,000 in the UK and France.
Posted 22 Jun 2008 at 5:39 pm ¶James, I think the increasing costs of delivering care are across the board. It includes new technology, compliance with new government regulations, cost shifting due to lower Medicare reimbursements and new courses of treatment. I would like to see a way to place higher cost sharing requirements on individuals that do not take care of themselves. I think a wellness aproach is vital, as we do not want to go to an abyssmal system like the NHS.
Posted 23 Jun 2008 at 9:24 am ¶Post a Comment