Dale and I once interviewed Ezra Klein about health care on our podcast. Klein held the VA system up as a shining example of good government health care. Of course that was before the shameful condition of Walter Reed had been discovered. Since then other problems (for instance, contaminated colonoscopy equipment in various locations) have been discovered.
A commenter once asked “if VA is good enough for our veterans, why isn’t it good enough for us.” My answer was “it isn’t good enough for our veterans, it is instead what they’re stuck with.”
Today brings another example of the problems this sort of medicine is bound to have. It is a bureaucratic nightmare, even at the relatively small size of VA.
For patients with prostate cancer, it is a common surgical procedure: a doctor implants dozens of radioactive seeds to attack the disease. But when Dr. Gary D. Kao treated one patient at the veterans’ hospital in Philadelphia, his aim was more than a little off.
Most of the seeds, 40 in all, landed in the patient’s healthy bladder, not the prostate.
It was a serious mistake, and under federal rules, regulators investigated. But Dr. Kao, with their consent, made his mistake all but disappear.
He simply rewrote his surgical plan to match the number of seeds in the prostate, investigators said.
The revision may have made Dr. Kao look better, but it did nothing for the patient, who had to undergo a second implant. It failed, too, resulting in an unintended dose to the rectum. Regulators knew nothing of this second mistake because no one reported it.
That as they say, was the tip of the iceberg. No one reported the problem because there was no peer review. And, this was one of many mistakes made by this doctor that apparently no one knew about:
Had the government responded more aggressively, it might have uncovered a rogue cancer unit at the hospital, one that operated with virtually no outside scrutiny and botched 92 of 116 cancer treatments over a span of more than six years — and then kept quiet about it, according to interviews with investigators, government officials and public records.
The team continued implants for a year even though the equipment that measured whether patients received the proper radiation dose was broken. The radiation safety committee at the Veterans Affairs hospital knew of this problem but took no action, records show.
Six years and no one had a clue. In fact, if you read the article in full, as you should, you’ll see that the discovery of this was essentially an accident.
This is government health care. This is what our vets are stuck with. This is not something we, as a society, should want any part of.
Michale Barone, observing the Obama presidency as it unfolds, has penned his own “Three Rules of Obama”.
First, Obama likes to execute long-range strategies but suffers from cognitive dissonance when new facts render them inappropriate.
Barone cites Obama’s long range strategy of conciliatory diplomacy with the likes of Iran and North Korea being “undercut by North Korea’s missile launches and demonstrations in Iran against the mullah regime’s apparent election fraud.”
His assumption that friendly words could melt the hearts of Kim Jong Il and Mahmoud Ahmadinejad have been refuted by events. He limits himself to expressing “deep concern” about the election in the almost surely vain hope of persuading the mullahs to abandon their drive for nuclear weapons, while he misses his chance to encourage the one result — regime change — that could protect us and our allies from Iranian attack.
Obama apologist continue to insist his policy of “restraint” is the right course. Events and history seem to argue otherwise. Bottom line: not very agile when his presumptions are shattered.
Second, he does not seem to care much about the details of policy.
The “closing” of Guantanamo is perhaps the perfect example. Obviously politically satisfying at the time it was announced, its execution has been an absolute fiasco. None of the underlying problems of closing the prison had apparently been researched or considered when the promise was made.
And that’s not the only example:
He subcontracted the stimulus package to congressional appropriators, the cap-and-trade legislation to Henry Waxman and Edward Markey, and his health care program to Max Baucus. The result is incoherent public policy: indefensible pork barrel projects, a carbon emissions bill that doesn’t limit carbon emissions from politically connected industries, and a health care program priced by the Congressional Budget Office at a fiscally unfeasible $1,600,000,000,000.
Obama sees himself as the grand vision guy and it is up to his minions to put his vision together. Of course, that sort of outsourcing is bound to come up against competing agendas. He doesn’t seem to take that into account, apparently doesn’t do the necessary work to assure his version of his agenda is the dominant one and the result is chaos. Bottom line: his legislative and executive inexperience is the worst enemy of his aggressive agenda.
Third, he does business Chicago-style.
“Transparency” and “openness” are now just a words as he and his administration begin to insist on more and more executive privilege. And there’s also the example of the IG mess, not to mention the stories of threats and intimidation toward auto company bond holders and banks.
From Chicago he brings the assumption that there will always be a bounteous private sector that can be plundered endlessly on behalf of political favorites.
Just ask the UAW (and other unions) and ACORN. And Barone uses precisely the right word here – plunder. All of his grand plans are based on plundering the rich and redistributing the spoils to favorites. A more destructive presidency is hard to imagine.
Hope and change.
If ever there was a text book example of a false premise wrapped in an absurd ‘moral’ analogy, Glenn Smith at Firedoglake provides it:
The gravity of America’s health care crisis is the moral equivalent of the 19th Century’s bloody conflict over slavery. This is not hyperbole, though the truth of it is often lost in abstract talk of insurance company profits, treatment costs, and other cold, inhuman analyses.
Today’s health system condemns 50 million Americans to ill health and death while guaranteeing health care to the economic privileged. It cannot stand.
About 18,000 Americans die each year because they lack health insurance. That’s more than a third the number of lives lost in battle during each year of the four-year Civil War.
Heh … you have to love the attempt to wave off this hyperbole by simply declaring it isn’t hyperbole. But I would hope that it is evident to any rational thinker that the attempt here is to equate those who resist the intrusion of government into the realm of health to those who fought to retain the institution of slavery.
This is, instead, a plain old rant against capitalism and the free market cloaked in this absurd moral equivalence Smith invents. Seeing the liberal goal of government run health care being battered by real world realities, he’s decided he has to turbo-charge his argument for such change by defining down the horror of slavery in order to find a moral equivalence he can use as a bludgeon on the dissenters.
Don’t believe me? How about this:
Members of Congress without the moral clarity to recognize this equivalence will be condemned by history. Their spinelessness and lack of will when confronted with the power of the insurance industry is just as morally bankrupt as the American congressmen who bowed to Southern slave-owners.
The morally compromising efforts to pass health care reform that insurance companies might like is as insane as the compromises over slavery.
The health insurance industry earns its profits from the denial of coverage and benefits. It’s not so different from the Southern plantation owners who earned their profit from slave labor. The latter had their economic justifications for their immorality. So do the insurance companies.
Of course, this sort of nonsensical thinking muddles important concepts that underlie the inalienable rights of man. Slavery was a violation of man’s right to his own life. Health care insurance is nothing more than a tool that helps pay for a person’s health care. Health care is not “unavailable” to those who don’t have it. More importantly, health care is not a right.
Whereas slave owners physically denied slaves the freedom to pursue their lives, insurance companies do not stop anyone from pursuing their own health care.
But – they have to pay for it because it entails the use of the time, abilities and services of others. That is what people like Smith really object too. Read the nonsense in the paragraph above and that’s clear. And, as many extremists like to do (like those who claim, for instance, that those who don’t agree on AGW are akin to Holocaust deniers), he chooses the most inflammatory but false “moral” example he can choose to demonize his opposition, counting on the dearth of critical thinking these days to win their point.
Unfortunately, it is more successful than I’d like to admit, which is why it is important to refute it immediately when it crops up.
Some conversation starters:
- For new readers, the title is what the shortened “QandO” means.
- I’m constantly amused by the anecdotal evidence I gather while on the road that says if you’re over 65 you have to drive a Buick.
- One thing to keep in mind as you listen to all of these proponents tell you that government can do health care better than the private sector – The private sector is a net producer of wealth. The government sector is a net consumer of wealth. That’s why the more of the economy a government takes over the less wealth is produced and thus available within the economy.
- Interesting chart showing the level of spending in the last 12 months compared to the spending over the last 206 years in inflation adjusted dollars. How do people believe that such a massive increase in spending doesnt have to be paid for at some point?
- Is Obama’s honeymoon over? Is enough resistance building to derail some of these economy killing policies and programs now on the table?
- Former President Bush speaks out, apparently tired of a president 150 days into his own administration continuing to blame the previous administration. Appropriate or should he remain silent? And interestingly, since the left excused Jimmy Carter’s criticism of the Bush administration, does that mean they’re fine with Bush speaking out?
- Is it “IGgate”? What’s up with this story about the Americorps IG and are there more IGs with whom the administration has messed? Wasn’t this the administration which was going to “return” us to the “rule of law”? Why aren’t they following it?
Daniel Henninger gives us a little walk down memory lane to remind us of the effect of our first attempt at “health care” reform.
Back before recorded history, in 1965, Congress erected the nation’s first two monuments to health-care “reform,” Medicaid and Medicare. Medicaid was described at the time as a modest solution to the problem of health care for the poor. It would be run by the states and “monitored” by the federal government.
The reform known as Medicaid is worth our attention now because Mr. Obama is more or less demanding that the nation accept another reform, his “optional” federalized health insurance program. He suggested several times before the AMA that opposition to it will consist of “scare tactics” and “fear mongering.”
Whatever Medicaid’s merits, this federal health-care program more than any other factor has put California and New York on the brink of fiscal catastrophe. I’d even call it scary.
Anyone who has paid any attention to the health care debate know full well that Medicare and Medicaid have become huge black holes with future funding obligations in the tens of trillions of trillions of dollars.
Now, pointing that out and doubting the government’s ability to do any better is apparently “scare tactics” and “fear mongering”. Reminds me of the AGW nonsense.
After 45 years, the health-care reform called Medicaid has crushed state budgets. A study by the National Governors Association said a decade ago that because of “new requirements” imposed by federal law — meaning Congress — “Medicaid has evolved into a program whose size, cost and significance are far beyond the original vision of its creators.”
There is nothing to convince anyone that the same won’t happen with a “public option”. And although the present plan is to have such an option pay for itself through premiums, there’s nothing to stop Congress from deciding the taxpayer should pick up the tab at some point in the future.
In his speech, Mr. Obama said the cost of the Public Option won’t add to the deficit: “I’ve set down a rule for my staff, for my team — and I’ve said this to Congress — health-care reform must be, and will be, deficit-neutral in the next decade.” If we’re honest, that means tax increases are inevitable.
The thing to remember – “deficit-neutral” doesn’t necessarily mean cuts in spending. It means that revenue must equal spending and that obviously means that spending increases must have added revenue – tax increases.
There is some resistance starting to form to the “reform”. The Democrats plan on rushing this through with limited debate. If they succeed, “Son of Medicare” will wander out the government lab and bankrupt this nation much more quickly than now anticipated.
Cato Institute is hosting a conference on health care reform today that will be webcast live. It will feature the following speakers:
* Rep. Paul Ryan (R-WI)
* Rep. Michael C. Burgess, M.D. (R-TX)
* Rep. Jason Altmire (D-PA)
* Karen Davenport, Director of Health Policy, Center for American Progress
* Douglas Holtz-Eakin, Former Director, Congressional Budget Office, and Director of Domestic and Economic Policy for the McCain presidential campaign
* Tom G. Donlan, Barron’s
* Karen Tumulty, Time Magazine
* Susan Dentzer, Health Affairs
* John Reichard, Congressional Quarterly
This represents a wide range of views and promises to be much more interesting and informative than the White House/ABC News infomercial scheduled for next week. so if you’re interested in this topic at all, take some time to check it out.
In one of those “make sure you read the whole article” stories in the Washington Post, it begins like this:
The Obama administration has turned back pleas for emergency aid from one of the biggest remaining threats to the economy — the state of California.
Top state officials have gone hat in hand to the administration, armed with dire warnings of a fast-approaching “fiscal meltdown” caused by a budget shortfall. Concern has grown inside the White House in recent weeks as California’s fiscal condition has worsened, leading to high-level administration meetings. But federal officials are worried that a bailout of California would set off a cascade of demands from other states.
If you read no further than that, you’d probably think, “thank goodness, a modicum of sanity has returned to the federal government”. It is California’s mess and California, along with the other states, need to learn a hard but necessary fiscal lesson here.
But, while perfectly correct in your assessment, you’d be wrong to think that the present rejection is final. Buried a few paragraphs down is this:
These policymakers continue to watch the situation closely and do not rule out helping the state if its condition significantly deteriorates, a senior administration official said. But in that case, federal help would carry conditions to protect taxpayers and make similar requests for aid unattractive to other states, the official said. The official did not detail those conditions.
I’m sure he or she didn’t. This is another Geithner plan based in the premise that California is “too big to fail” – the 8th biggest economy in the world and its failure would slow down the economic recovery of the US.
Given that inclination on the part of Geithner, it would appear that nothing has been learned from the Chrysler and GM bailouts, failure and eventual bankruptcies. Granted, California’s “failure” would be quite a bit larger than those two, but haven’t we yet learned that propping up a unsustainable business or government model just doesn’t work?
While it may be painful for both California and the US, nothing changes in California unless massive cuts and changes are made in that government. And, as has been evident to even the most tuned out of constituents, the California government model has been unsustainable for over a decade.
Naturally, California wants to characterize their plight in the way that will appeal the most to the emotions:
“After June 15th, every day of inaction jeopardizes our state’s solvency and our ability to pay schools and teachers and to keep hospitals and ERs open,” Gov. Arnold Schwarzenegger (R) said Friday.
But the hard fact remains that the solvency of all those institutions are in jeopardy with or without a bailout. We’re simply talking about how long we want to extend the problem not how to solve it. Solutions mean massive cuts in government spending and resultant reductions in government services. Or said another way, California is finally going to have to live within its means or fail.
That’s not a condition the rest of the taxpayers in this country brought about, and it certainly isn’t one they should be on the hook to “bailout”. And that goes for every other state in that condition as well (see the article and its mention of how Treasury is thinking about doing something with auto suppliers in Michigan – is that the job of Treasury).
I‘m not sure what part of this Obama doesn’t understand.
On the one hand, he told doctors at the AMA convention yesterday that he was not a fan of tort reform and felt that limits on malpractice cases was a disservice to those who were truly injured.
On the other hand he made this case:
Not long ago, doctors’ decisions were rarely questioned. Now they are being blamed for a big part of the wasteful spending in the nation’s $2.5 trillion health care system. Studies have shown that as much as 30 cents of the U.S. health care dollar may be going for tests and procedures that are of little or no value to patients.
The Obama administration has cited such findings as evidence that the system is broken. Since doctors are the ones responsible for ordering tests and procedures, health care costs cannot be brought under control unless they change their decision-making habits.
Somehow, apparently, he doesn’t understand the linkage. But AP’s Ricardo Alonso-Zaldivar thinks there’s a much more basic reason than Obama not understanding the linkage:
If Obama announced support for malpractice limits, that would set trial lawyers and unions—major supporters of Democratic candidates—on the attack. Not to mention consumer groups.
Somebody has to go under the Obama bus and the apparent choice is doctors.
USA Today led its story about Obama at the AMA convention with this:
President Obama told wary doctors Monday that the nation’s health system is “a ticking time bomb for the federal budget” and said those who call his plan for a taxpayer-funded coverage option a step toward a government takeover of health care “are not telling the truth.”
Of course the one “not telling the truth” in this case is President Obama. Any “public” option funded by taxpayers is not going to be competing on the same level of the playing field as private insurance carriers. Right now there are 1,300 private choices out there. The introduction of a taxpayer funded “public” option will, according to many economic and health care experts, end up seeing employers dump private health care coverage in favor of public health care coverage and eventually see the system become a single-payer public plan.
That’s why there is such fierce opposition to this sort of an option. Even those in favor of the public option know it is a means to single payer and willingly admit it. So to have the President stand up in front of a group of doctors and tell the whopper he told yesterday is disappointing but not unexpected. He’s lowballed the cost, he’s dissembled about how it is going to be paid for and now he’s being totally disingenuous about the eventual end-state a public option would bring.
It’s kind of hard to protest an election in court when you’re in jail.
Iranian presidential candidate Mir Hossein Mousavi was reportedly arrested Saturday following the reformist’s defeat at the polls by hardliner Mahmoud Ahmadinejad.
Mousavi’s arrest was reported by an unofficial source, who said that the presidential contender had been arrested en route to the home of Iran’s supreme leader, Ayatollah Ali Khamenei.
My guess – and that’s all it is – is this is a move to defuse the protests. It will also remove the last bit of the veneer from the belief that these were “free and open” elections. In some ways this makes Iran easier to deal with. There’s no longer any doubt that it is a totalitarian regime where no “robust debate” is taking place or possible.
Look – the fantasy that these were “free and open” elections was a sham to begin with. 475 people applied to run for the presidency. 4 were approved by the ruling mullahs. That should tell you all you need to know about this election. Even Mousavi had impeccable revolutionary credentials, or he wouldn’t have been one of the 4.
But the election appears to have taken an unexpected turn. It would seem those that voted for Mousavi and perhaps Mousavi himself, took it a little more seriously than the authorities expected. Supporters turned out in record shattering numbers (85% of eligible voters) to vote and simply aren’t buying this supposed “landslide” win the mullahs and IRG had put together to keep their guy in office.
Crude, certainly, but to be expected. Authoritarians don’t believe in the democratic process – never have. But they understand the power of popular approval – even if they have to fake it and fake it poorly.
Nothing makes it clearer than a real world examples. From socialized Canada:
The Lower Mainland’s health authorities will have to dig more than $4 million a year out of their already stretched budgets to pay B.C.’s carbon tax and offset their carbon footprints.
Critics say the payments mean the government’s strategy to fight climate change will further exacerbate a crisis in health funding.
“You have public hospitals cutting services to pay a tax that goes to another 100 per cent government-owned agency,” NDP health critic Adrian Dix said.
“That just doesn’t make sense.”
Heh … it would really be funny if it wasn’t so absurd or headed in our direction like a runaway freight train.
Enjoy those “little green shoots” of growth, because they’re going to be as dead as the Mojave desert if “health care reform” and “cap and tax trade” are passed.
And don’t even try to throw the “these people have your best interest at heart” canard out there either:
Dix warned that some of the potential cuts – such as closing the ER at Mission Memorial Hospital – would actually increase carbon emissions by sending patients further afield.
“Obviously when you shut down regional centres it makes people travel farther to get to their health care facility,” he said.
Vancouver Coastal chief financial officer Duncan Campbell said his health authority believes the payments are appropriate and isn’t asking for any exemption from Victoria.
“For us to go back and ask for an exemption wouldn’t fit in well with our green care plans,” he said.
IOW, your health is secondary to their sacred green mission.
Freakin’ amazing. And yes, it is entirely possible you’d be treated the same way here when government controls health care and is collecting on “cap and trade”. Remember, it was Obama who said he didn’t believe in cap and trade exemptions.
[HT: Wm Teach, RWN]