Health Care

But the evidence is right there – right there! – in front of you.

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(paraphrasing a conversation)

Me: Hi, I’m calling about my AMA dues notice?
AMA representative: Yes?
Me: I’m not a member currently. I’d like to be removed from your mailing list, please. I don’t plan on becoming a member any time soon, so I don’t need the dues notices.
AMA representative: Okay.

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From the AMA website a couple of days before the vote: “Washington, D.C. After careful review and consideration, the American Medical Association (AMA) today announced its qualified support for the current health reform bill as a step toward providing coverage to all Americans and improving our nation’s health system.”

Also from the AMA website (where they have a counter “counting down” to the 21% Medicare Physician cuts with the admonition to “take action now”:)

“Resolving the problem now is the fiscally responsible course to take. Relying on past methods of postponing the immediate crisis will only increase the cost of a permanent repeal. Congress can no longer afford to kick the can down the road.”

Does anyone want to explain the above statement to me? Seriously, I’m trying to understand what the organization might mean with that statement about fiscal responsibility – as they ask members to call and complain about cuts to physician medicare payments. What was that about CBO scoring again? I’m a dunce at all of this, so I ask for help from the readership! It’s a real question….

Bubble-icious — American History and Political Subsidies

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As someone who’s written several times (here and here) about the course of modern health care (its inherent complexity and cost), I’ve been watching the latest moves in US health care funding with a great deal of interest.

From the introduction of antibiotics to the breakthroughs in transplant surgery, medicine in the 20th century was in a position to provide dramatic improvements in health care (both quality of life and length of life) at relatively modest cost. Many consider it a golden age in medicine. My personal belief is that medical care is about to hit another burst of creativity and success (but at much higher cost-to-benefit) as non-invasive imaging, micro-surgery, diagnostic testing, and DNA-propelled pharmaceutical customizations kick in. I may be wrong, but I think my beliefs are a reasonable extrapolation of the trends in medical care since the end of the 1970s “silver bullet” period of medicine.

So what do my guesses about modern medicine mean in a new era of greater tax subsidies for US health care? An era which, by necessity, must politicize health care further. It got me to thinking about the hidden subsidies during earlier periods of American history, powered by the domestic political systems of the time, and driven by citizen/voter appetites. And it got me thinking about the law of unintended consequences.

After a few minutes scribbling on the back of an envelope, I came up with the following:

US Bubbles Over Four Centuries

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Silver Lining

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Dennis the Peasant has some lucid thoughts:

Much to my delight, I spent most of this week alternately entertaining and chauffeuring an old college pal who was visiting the wilds of Central Ohio. As opposed to sitting in front of a computer speculating about whether Obamacare would pass. I said last week that I thought it would pass, and it will. Anyone who was paying attention to Bart Stupack’s imitation of Hamlet should have known by last Thursday that he was never going to vote ‘no’.
 
So Obama and Pelosi will have their bill, and Democrats own health care for better or for worse.
 
Sure, it’s shitty legislation, but I can’t say I’m all that worried. If there’s one thing I’ve learned in 25.5 years of dealing with people and their money, it’s that they will do anything to ensure their standard of living is not lowered. And that’s why I think that much of Obamacare will never actually see the light of day. In the end the mandate will go away, rather quietly, and by mutual consent. Probably via an indefinite delay in implementation. People simply will not tolerate a government order to lower their standard of living; and demanding a family making $88,000 pre-tax to spend $15,000+ after-tax to fulfil Obamacare’s mandate is just that.
 
And while Obamacare does in many ways threaten our way of life, our liberty and so on and so forth, I’d be lying if I didn’t confess that it really has had its upside as well. It’s been pure, unadulterated joy to watch legions of sanctimonious, holier-than-thou progressives sell out for the sake of pure partisanship and/or personal gain. It’s been fun to watch the kept men like Markos Moulitsas, Matthew Yglesias, Josh Marshall and countless others ditch single payer and the public option as if they had never once considered either worthy of interest, much less their support.
 
We’re to the point where progressives are now out-Clintoning Bill Clinton. They’re now worse than the DNC Bill Clinton forced upon them. The DNC they loathed. The DNC they’ve so often derided as being so centrist as to be sell-outs. Now they’ve got health care reform written by AHIP and financed by PhARMA, and they couldn’t be happier. They’re now in the same league with boob-jumping evangelists, Hummer-driving treehuggers and spendthrift Republicans… and they couldn’t be happier.
 
Like I said, that almost makes it all worthwhile.

Obama Rubs Our Faces In It

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“We proved that this government, a government of the people and by the people, still works for the people.”

That’s what Obama said after House Democrats passed his health scheme. It’s a revealing remark. The Democratic leadership ignored broad public opposition to pass this extremely consequential bill on a bare majority by a combination of dishonest rhetoric, bribery, scummy parliamentary maneuvers and sheer willfulness. Then the President had the nerve to abuse Lincoln’s great words to tell us — most of whom opposed the bill, as he well knows — that he and his colleagues did it at our direction (“of the people and by the people”) and for our benefit. I interpret his words, a characteristic inversion of the truth, as a direct insult to his political opponents, who on this issue are now the majority of the country. He knows that we know he is lying and he doesn’t care, because he thinks he can get away with it. And he appears to enjoy it. This is not someone who can be trusted with power.

Quote of the Day

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The President has just given away the contents of half the nation’s wallets by arranging things so that the survival of the other half depend on getting it.

–Richard Fernandez