But Mr. Obama has grown concerned that he is losing the debate over certain policy prescriptions he favors, like a government-run insurance plan to compete with the private sector, said one Democrat familiar with his thinking. With Congress beginning a burst of work on the measure, top advisers say, the president is determined to make certain the final bill bears his stamp.
Obama to take a greater role on health care
20 comments on “Obama to take a greater role on health care”
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Hey, prove to me first y’all actually know what you’re talking about — [b]fix Medicare first[/b]. Medicare is a monumental mess, and they wish to force me into it by threatening removal of my Social Security income if I don’t go along. Bureau of Indian Affairs medicine is a horror show. The VA is widely miserable.
We have three ongoing case studies of utter incompetence in government health care. Walter Reed, anyone?
Please, Please, PLEASE … [b][i]demonstrate[/i][/b] you can actually run a government health care system before you try to force me into one. I lived in Canada for more than two decades, and their system was great if you broke an arm or needed stitches. IF, however, you actually got sick … things weren’t so good.
Obama is pushing a measure that will require employers to provide healthcare coverage for employees or pay stiff fines. Can anyone imagine the number of small businesses that will be snuffed out as a result? The number of startups that will be strangled in their cribs?
And can anyone point me to the passage in the Constitution that authorizes this?
Jeffersonian – can’t argue your second point. However, try to imagine how many small employers (like me) are being snuffed by the insurance ‘market’ and what it is doing to my ability to provide coverage for employees (and my business is that of a physician office!).
I can’t imagine what this country will be like if Universal Healthcare comes under government control. I’m old (eighty) and have had enough experiences with Medicare to know that anything the government beaurocrats get involved in will be a mess. My Medicare Supplement Plan (private) helps a lot, but even then, the bureaucrats will screw it up. My wife was dying with cancer and needed a new treatment that could possibly save her. Some bureaucrat said a new treatment that might save her life was “not approved!†After applying all the pressure I could, even to the point of paying for it myself, she got the treatment too late to stop the cancer and she died.
There is an old saying that fits government mandated healthcare: “Anything the government can do to help me, I can do better..and cheaper.â€
[blockquote]However, try to imagine how many small employers (like me) are being snuffed by the insurance ‘market’ and what it is doing to my ability to provide coverage for employees (and my business is that of a physician office!). [/blockquote]
I don’t doubt it, Montanan, given the amount of cost-shifting going on with government programs. But at least now you have the option of going to another insurer, cost-sharing with your employees or dropping coverage altogether. Imagine it when you’re mandated to provide a federally-specified level of coverage without employee cost sharing.
Tell me, when you think of federal programs, do the words “cheap” and “well run” snap to mind?
Since Republican conservatives don’t believe in government, they are the last people you’d want managing it. They just aren’t interested in such management, because good management would disprove their hypothesis.
So no, whenever a Republican manages the government, “well-run” should NOT enter your vocabulary. Because they don’t believe its is possible.
Expectations are crucial to results.
“a government-run insurance plan to compete with the private sector”
As in the case of Medicare, a government-run insurance plan will kill the private sector. That is the intent. And Medicare has been wasteful and inefficient under a variety of administrations of both parties. These characteristics are in its nature.
John keeps repeating half-truths. Republicans don’t believe in “no government”, but rather government limited to those powers granted by the constitution. Libertarians are those who believe in ‘almost no government’ and liberals believe in ‘almost total government.’
#8 – libraryjim: liberals believe in total government? That’s ridiculous. Like opposing wiretapping of citizens? It’s not a very accurate view of what “liberals” believe.
Liberals do believe, perhaps, that our congress should be able to make and enforce laws for the common good. Which is the nature of a government. But I suspect you are confusing partisan politics with a philosophy. I do believe that the USA is a bit different than Soviet Russia, historically and culturally, but I appreciate your fears. I always took a dim view of leftists who thought the USA was really a totalitarian country, but I’m intrigued that you share their view.
Jim, there are lots of people who want a free lunch. They don’t want to pay for sewage, clean water, roads or the like. They benefit from an educated population, but hate to pay for schools. They benefit from a state that protects property rights, but they don’t want to pay for it. There are aspects of a commercial, or capitalist society that we take for granted.
Katherine, Medicaid has less overhead than most insurance companies. Butas Atul Gawande noted, on reason all expenses are going up is because patients are treated like profit centers.
Until patients are treated as patients, rather than commodities, expenses will increase. Unfortunately, in the current system of arrangements, there are no disincentives for that kind of behavior.
[Ad hominem comment deleted by Elf – please be careful to address issues on the topic, not commenters]
[blockquote]Jim, there are lots of people who want a free lunch. They don’t want to pay for sewage, clean water, roads or the like. They benefit from an educated population, but hate to pay for schools. They benefit from a state that protects property rights, but they don’t want to pay for it. There are aspects of a commercial, or capitalist society that we take for granted. [/blockquote]
Have you ever noticed that when one questions the government’s power and wisdom to, say, force everyone into a healthcare collective, use CFL bulbs, drive a car that gets a certain gas mileage, control what is said on talk radio, prop up failed corporations, etc., John’s first thing is to vow to take away our water, sewer and roads?
John, is it your contention that we can’t have paved streets without Medicare? Why is that?
To quote my nephew: “The scariest words in the English language are ‘I’m from the government and I’m here to help you.'”
Part of the problem with the “It’s for the common good” rationale is that it is a bottomless pit. We could spend ten times what Obama and (JW) want to spend and a year later it would not be enough. And, as many have noted, the modern government is primed to spend. That’s how politicans get elected and re-elected and how government justifies its existence–spending other people’s money.
JW #9, my comment was about Medicare, not Medicaid.
I worked as a nurse in England at a National Health Hospital. I was assigned to a rehab unit that was mostly post-stroke patients. Average age for our patients was 50-ish and up. My first day on the job, I asked the head nurse, “How do I know which patients are DNR (Do Not Resuscitate – an OPTIONAL designation here) and which are to be ‘coded’?”. Her response? “EVERYONE’S a DNR.”
And when we passed out medications, after completing a pass, the med nurse would take those little plastic medicine cups that had just been used, a wash them with dish liquid in the clean utility room so they would be ready to re-use at the next medication time. Those cups are single-use items. And the dish liquid and hot water temp at the sink were not adequate to sanitize those cups.
I could go on and on.
15, well we probably could go back to reusable supplies and autoclaves. We don’t have to use all this disposable stuff.
#16 –
I agree w/you. But they had us re-using single use items and we weren’t employing any means of sanitizing these plastic med cups. Just washing w/plain dish liquid in mildly warm water won’t kill germs. But if items are designed for re-use and sterilization I’m all for it. I’ve been a nurse for 26 years and we re-used equip much more then than now. Remember genuine metal or porcelain bedpans?
While I am not yet sold on goverment sponsord health care for everyone, I think conservatives need to come up with a better argument, than the level of care will be inferior.
The United States spends a larger percentage of its GDP on health care than almost any other country in the world; yet, England, Germany, Austria, Italy, Denmark Sweden, Norway, France, Spain, Canada, Australia, New Zealand, Japan, Switzerland, the Netherlands, and Belgium (all of whom have goverment sponsored health care) have all surpassed United States in life expectancy and all have lower infant mortality rates.
Consequently while you may talk about everyone being a DNR in England, the simple fact is if you live in England, or any of the other countries listed above, statistically you and your children are likely to live longer than if you live in the United State.
#18 And who’s going to be left to lead the way in R & D, particulary in medicines? Very expensive business, that must be paid for some way. And regarding the DNR, don’t you find it a bit alarming that our patients had no say in that policy? When you give the gov’t the responsibility, you also give it all of your power. I’ve lived both systems. Neither is perfect. Ours is better.
To Mitchell’s #18: The best argument ought to be that the Constitution allows no such role for either the President or the Congress. Quality of care is merely a pragmatic argument.
I would ask a few questions:
– Why is % of GDP a valid measure? It’s not like there’s a central body producing wealth and deciding how it should be apportioned… yet.
– Why should life expectancy and infant mortality be the only valid outcomes? Can these things be affected by factors besides % of GDP?
– WHY do USA outcomes (these two, anyway) lag the other nations cited? There must be a reason, so perhaps it would be interesting to assess it.
– Perhaps among those reasons (I don’t know, I’m just wondering) might be the level of preventive care, the quality of care, the availability of care, the level of technology, the amount of diagnostic tests, the amount of diagnostic tests administered to ward off liability, the cost of torts and malpractice insurance, the cost of government mandates and oversight, the % of discretionary “care” – “lifestyle” meds and procedures that may not be medically necessary and yet in some cases the gov’t mandates payment! – and perhaps there are other factors.
Also, it seems to this insurance company employee (I’m in IT, though!) that the insurance companies always take the full brunt of the criticism and blame. But let’s remember that it’s plan sponsors (like GM) who determine the level of coverage, which in turn affects the cost; of course, that’s compounded by gov’t mandates as well. Let’s also not forget that insurance companies are middle-men; which you might think superfluous, and I might agree, but let’s be honest enough to admit that we’re simply expecting the gov’t to supplant the insurance industry and become the new middle-man. And because they’re only middle-men, the money is largely flowing through them… but nobody wants to criticize doctors, nurses, aides. therapists, hospitals, labs, pharmacies, pharmaceuticals, and makers of MRI, CT, EKG, defib equipment or supplies.
Last thought about the discrepancy and government: how many of those countries have competing and overlapping regulatory environments across 50 jurisdictions plus the national level?
I don’t claim to have all the answers to the problem, and I believe the gov’t does have some legitimate roles to play in the system. But I don’t believe that can or should be the primary solution.