[Robert] SIEGEL: Mr. President, some people have faulted this whole process for not focusing enough on how medicine is practiced in the U.S. and our appetite for lots of tests and the like. I want to ask about a recent, coincidental event, which would be the new guidelines on mammography. They suggested that we’ve been testing too much and it would be better to get tested less. There was an outcry. Your own secretary of HHS backed away from the new recommendations. What does that say to you about how best practices can actually be instituted in the country?
{President] OBAMA: Well, I think what it says, No. 1, is that we still have a tendency to think that more medicine is often ”” is automatically better medicine. And that’s just not the case. Inside this reform bill that I’m pushing is a provision that has a panel of experts ”” doctors, medical experts ”” who are going to look at all these practices to start changing how we think about medicine.
SIEGEL: Will politicians defer to their judgments ”” to their scientific judgments?
OBAMA: Well, one of my goals is to make sure that doctors and scientists are giving the best information possible to other doctors who are seeing patients. Look, if you talk to most health care economists right now, they will tell you that every good idea out there, when it comes to improving quality of care and reducing costs of care, are embedded in this bill. It’s not going to happen overnight because we’re going to have to change both how doctors think about health care and how patients think about health care.
And there are going to be millions of small decisions all across the country and interactions between doctors and patients that, over time, change the trajectory of our health care system. The important point is that we’re getting started in this process. And I’m actually very confident that the average person is going to say to themselves, if, right now, I’m taking and paying for five tests and my doctor tells me that I only need one, that person’s going to want to take one ”” save some money and save some time. But they need some validation. They need somebody who’s giving them the better information. And we have set up a system where, year after year, best practices are going to get disseminated across the country.
[blockquote]Inside this reform bill that I’m pushing is a provision that has a panel of experts — doctors, medical experts — who are going to look at all these practices to start changing how we think about medicine.[/blockquote]
Why does that comment NOT giving me a good feeling?!
“Well, I think what it says, No. 1, is that we still have a tendency to think that more medicine is often — is automatically better medicine.”
What’s wrong with a person receiving the amount of “medicine” that he/she is willing to pay for via his/her own private medical insurer without government becoming involved? What is wrong with that? The only caveat that I would offer is that the medical services offered should be offered in a ‘free market’ environment that permits a ‘flat playing field’ for price-competition and innovative entrepreneurship.
#1–In the latest iteration, the determinations of the Death Panels are supposedly unreviewable, and their unilaterally-determined policies supposedly cannot be changed even by Congress (Section 3403 of the bill). This violates so many principles of common law, due process, civil rights, and the Constitution it’s just leaving lawyers shaking their heads.
Jim: And the NY Times (on their front page, no less!) spread the “word” that “death panels” were the biggest lies of 2009! Boy, would I like to hoist that editor from the highest pitard I could find!
OK, guys (nos. 3 and 4), help us out here. Does the Senate Bill establish Death Panels? If so, do they impose death in individual cases or do they execute (or consign to non-treatment) classes of patients? Would a non-governmental, non-legislatively required “best practices” Board of Medical Experts (or insurance providers) that addressed gerontology and terminal illness treatment protocols be more or less morally reprehensible than whatever is in these bills?
My major concern about the health care legislation is its costs measured against its benefits. If we can’t afford it, we shouldn’t be doing it. The current system is so slap-dash that I can imagine that there is a good argument that its costs are prohibitive for the Nations. But it’s virtually impossible for even the most diligent citizens to net out the C/B ratios. One certainly doesn’t get the impression that either chamber of Congress or the White House has the stomach for dismantling the jury-rigged practice of imposing the country’s health care burden on employers.