Free Markets, Free People

Monthly Archives: June 2010

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The market speaks: doctors increasingly turning down new Medicare patients

USA Today brings us a story that should surprise no one. Medicare, the supposed model of a government run health care system, is finding that fewer and fewer doctors are willing to take on new patients under that system. They cite the low payments Medicare offers (or perhaps forces) for patient treatment. Baby boomers just now entering the system are going to find their choice of a doctor restricted.

The numbers break down like this:

• The American Academy of Family Physicians says 13% of respondents didn’t participate in Medicare last year, up from 8% in 2008 and 6% in 2004.

• The American Osteopathic Association says 15% of its members don’t participate in Medicare and 19% don’t accept new Medicare patients. If the cut is not reversed, it says, the numbers will double.

• The American Medical Association says 17% of more than 9,000 doctors surveyed restrict the number of Medicare patients in their practice. Among primary care physicians, the rate is 31%.

Note especially that final group. Primary care physicians are the group of physicians that the newly passed health care reform law depends on to implement its “preventive care” regime.

The reason is rather simple and straight forward – Medicare offers 78% of what private insurance pays in compensation for a doctor’s services. Why doctors are leaving or restricting new Medicare patients is rather easy to understand as well:

“Physicians are saying, ‘I can’t afford to keep losing money,’ ” says Lori Heim, president of the family doctors’ group.

Consequently they cut or drastically restrict the source of the loss. While most doctors are not going to turn away existing Medicare patients, they may not accept new ones and finally, through attrition, close their practice to Medicare patients.

It isn’t rocket science – no good businessman is going to continue to do things in which the net result is a loss of money. And a doctor’s private practice is a business – one which employs a number of people. He or she, like any business person running a small business, cannot afford the losses. So they identify the problem and eliminate it.

As this continues it will put them in a direct confrontation with the federal government. It is anyone’s guess, given the current administration’s choices for wielding power, how that will turn out. But what this rejection of the compensation offered by government is doing is bringing to the fore is one of the underlying conflicts of the new health care law – the premise of the law is that government can control costs (and payments) and thereby make medical care less costly. The doctors are saying, go for it, but I’m not playing.

At some point, government is going to have too address those who make that declaration. We’ll then see how free of a country we really are, won’t we?

~McQ


Even Al Qaeda knows Obama’s star is falling

Interesting that after the news breaks than the withdrawal timeframe for Afghanistan is "firm", al Qaeda pokes its head out of the cave and pretends like it winning this 9 year confrontation by dictating terms of "peace".

Al Qaeda’s American-born spokesman has repeated the terror group’s conditions for peace with America in a video released Sunday.

Adam Gadahn called on President Barack Obama to withdraw his troops from Iraq and Afghanistan, end support for Israel, stop intervening in the affairs of Muslims, and free Muslim prisoners.

Many would argue the “conditions” Gadahn sets are, in fact, the Obama agenda. He’s just been unable to execute it to his or their satisfaction yet. The announcement of this past week about the withdrawal of troops from Afghanistan being firm, however, certainly fits those parameters.

Another interesting point from Gadahn’s 24 minute video:

In white robes and turban, Gadahn told Mr. Obama: “You’re no longer the popular man you once were, a year ago or so.”

When al Qaeda is aware of that, perhaps the spinmeisters here ought to get a clue and quit spinning so hard. The cold wave of reality has indeed washed over their puny efforts to say it ain’t so.

~McQ


Observations: The Qando Podcast for 20 Jun 10

In this podcast, Bruce and Dale discuss the dissatisfaction about President Obama’s competence, the oil spill, and the American stranded in Egypt.

The direct link to the podcast can be found here.

Observations

The intro and outro music is Vena Cava by 50 Foot Wave, and is available for free download here.

As a reminder, if you are an iTunes user, don’t forget to subscribe to the QandO podcast, Observations, through iTunes. For those of you who don’t have iTunes, you can subscribe at Podcast Alley. And, of course, for you newsreader subscriber types, our podcast RSS Feed is here. For podcasts from 2005 to 2009, they can be accessed through the RSS Archive Feed.


BlogTalk Radio – 8pm (EST) Tonight

Call in number: (718) 664-9614

Yes, friends, it is a call-in show, so do call in.

Subject(s):

Oil spill – it continues and the politics heat up.

Is Obama incompetent and an amateur – Mort Zuckerman and a growing number of world leaders may think so.

No-fly list limbo – how does an American end up not being able to get back to the US and is it Constitutional?


Happy Father’s Day

I’m proud to be able to say my dad was my hero. I was fortunate enough to have him around for 46 years. He died at age 78.

He was a good, decent, honorable man who did his best to teach his 3 sons what they needed to know to be men of honor. He was that. His word was his bond and a handshake was all you ever needed from him to know you had an irrevocable contract with him.

He was a 36 year career Army man. He joined as a private, worked his way up to the highest Non-commissioned officer rank and then went to Officer Candidate School. He rose to the rank of Colonel. He used to joke that he’d held every rank but warrant officer and general officer.

He was a cavalry officer – recon in those days. He always ragged me about being a grunt and loved the ground his only grandson walked on because he too had become a cavalryman.

There are things you remember about your dad. His sense of humor. He loved a good joke. His self-discipline. He always suffered bad health – he’d lost a lung in WWII, had emphysema and asthma. But he never let it stop him. Never. And when the doctors would tell him he had to do something, he did it, without fail and consistently.

He did everything else in his life the same way. Having to deal with those sorts of health problems and still try to maintain a career in the Army in combat arms wasn’t easy. But he did it.

He used to tell us, “you live between your ears”. We knew what he meant, and I can’t tell you how many times those 5 words have come back to me as I face some difficulty or daunting problem. Once you realize where you “live” life isn’t at all as tough as it could be.

He also used to tell us that honor could be summed up by “doing the right thing, even when no one is looking”. He said, that’s what honorable men always do. He was right.

He wanted what was best for his boys. He was a disciplinarian of the first degree and none of the 3 of us are worse for wear because of it. In fact, with a good moral grounding and him as an example, I think we all were given the basics in life which gave us a chance to be what our dad was – a good man.

Of course my mom was involved in all of this as well, but this is Father’s Day, and I wanted to honor him. I’m 62, a grandfather and I still miss my dad. I’d give anything for a couple of hours just to show him his grandson and his 4 great-gransons (he never got to see any of them). He’d love that.

So give your dad a hug today and tell him how much he means to you. Some day you’ll be glad you did.

Happy Father’s Day.

~McQ


Dale’s Observations For 2010-06-19

Someone seems depressed at her beach imprisonment. http://twitpic.com/1y90d2 #

Beach setup complete. Happy dogs play in the shade. http://twitpic.com/1y8z9k #

Getting the dogs set up on the beach. http://twitpic.com/1y8yd7 #

Getting ready to take the dogs to the beach. Hopefully, this will tire them out so much that they sleep through the rest of the weekend. #

Iranian cleric says dogs are unclean. Also, doesn't dig on swine, even if they're 10 times more charming than Arnold from Green Acres. #

I've been using Swipe for a couple of days now, and it really is incredible. Its made my phone about 100% more useful. #


Has the world fallen out of love with Obama?

Mort Zuckerman, editor-in-chief of US News and World report writes a blistering piece that certainly seems to indicate that’s the case. Zuckerman says the world sees Obama as “incompetent and amateur” and that on the world stage he is “well-intentioned but can’t walk the walk”. That’s a nice way to say he’s a lightweight in an arena where only seasoned heavyweights prosper.

Zuckerman’s opinion is not one to be taken lightly. He was a huge Obama backer. He voted for him. His newspaper, the NY Daily News, endorsed him and was enthusiastic in his support of the Obama candidacy.

Now, 16 months into his presidency, he’s obviously very disappointed in his choice. And, it would appear, has come to understand that which he didn’t know or didn’t bother to find out about Obama at the time – that he has no leadership skills or abilities and is, in fact, more of an academic than a Commander-in-Chief.

Zuckerman is a keen and long time observer of American foreign policy, and as such he has the ability to compare and contrast what American foreign policy has seemed like under different presidents and under this one. He begins his critique of Obama by saying he actually inherited a “great foreign policy legacy enjoyed by every recent US president.”

Of course to hear Obama talk about it you’d think he’d been handed the worst mess in the world. But even assuming that, what has Obama done? Not much – and that’s beginning to become evident to the rest of the world. Says Zuckerman:

Yet, the Iraq war lingers; Afghanistan continues to be immersed in an endless cycle of tribalism, corruption, and Islamist resurgence; Guantánamo remains open; Iran sees how North Korea toys with Obama and continues its programs to develop nuclear weapons and missiles; Cuba spurns America’s offers of a greater opening; and the Palestinians and Israelis find that it is U.S. policy positions that defer serious negotiations, the direct opposite of what the Obama administration hoped for.

So success in the field that is exclusively the President’s has been elusive. Then there’s Obama the “leader”:

The reviews of Obama’s performance have been disappointing. He has seemed uncomfortable in the role of leading other nations, and often seems to suggest there is nothing special about America’s role in the world. The global community was puzzled over the pictures of Obama bowing to some of the world’s leaders and surprised by his gratuitous criticisms of and apologies for America’s foreign policy under the previous administration of George W. Bush. One Middle East authority, Fouad Ajami, pointed out that Obama seems unaware that it is bad form and even a great moral lapse to speak ill of one’s own tribe while in the lands of others.

Seems to be common sense to the rest of us, yet it is hard for anyone, even his most ardent supporters, to deny he’s engaged in more of that than any useful diplomacy.

Zuckerman also notes something I commented on months ago. He has no personal relationship with any of the world’s leaders. And that is critical to success in foreign diplomacy:

In his Cairo speech about America and the Muslim world, Obama managed to sway Arab public opinion but was unable to budge any Arab leader. Even the king of Saudi Arabia, a country that depends on America for its survival, reacted with disappointment and dismay. Obama’s meeting with the king was widely described as a disaster. This is but one example of an absence of the personal chemistry that characterized the relationships that Presidents Clinton and Bush had with world leaders. This is a serious matter because foreign policy entails an understanding of the personal and political circumstances of the leaders as well as the cultural and historical factors of the countries we deal with.

His meeting China was also a disaster and he was treated almost disrespectfully there. And he’s all but deep sixed our “special relationship” with the UK and certainly isn’t much loved by Sarkozy of France. Don’t even begin to talk about Israel.

These sorts of problems and perceptions have an effect in international affairs. A perfect example?

Recent U.S. attempts to introduce more meaningful sanctions against Iran produced a U.N. resolution that is way less than the “crippling” sanctions the administration promised. The United States even failed to achieve the political benefit of a unanimous Security Council vote. Turkey, the Muslim anchor of NATO for almost 60 years, and Brazil, our largest ally in Latin America, voted against our resolution. Could it be that these long-standing U.S. allies, who gave cover to Mahmoud Ahmadinejad and Iran’s nuclear ambitions, have decided that there is no cost in lining up with America’s most serious enemies and no gain in lining up with this administration?

So they go their own way in the absence of US leadership. This week, Russia’s President Medvedev criticized the US for placing additional sanctions on Iran, above and beyond the UN’s rather pitiful ones.

Obama has been a foreign affairs disaster to this point, and as Zuckerman points out, this has sent a very clear message to many of those out there who wish us ill as well as those who count themselves as allies:

America right now appears to be unreliable to traditional friends, compliant to rivals, and weak to enemies. One renowned Asian leader stated recently at a private dinner in the United States, “We in Asia are convinced that Obama is not strong enough to confront his opponents, but we fear that he is not strong enough to support his friends.”

I think at this point, that’s a perfectly defensible and accurate assessment. This is why I continue to say that there are some pretty heavy storm clouds brewing on the international horizon. US leadership is seen as missing or weak – a perfect time for those who take advantage of power vacuums to step forward and make their particular grabs for power.

Don’t be surprised to see it happen soon.

~McQ


Dale’s Observations For 2010-06-18

I hope the leadership vacuum created by Tony Hayward's departure doesn't hamper the #oilspill containment or cleanup efforts. #

Russia is eliminating the capital gains tax. Sadly, the ex-commies know something we apparently don't. http://bit.ly/cSzTOe #

Calling the AOL/Bebo fiasco the worst deal of the dot com era makes me wonder if nobody remembers Novell/Word Perfect. http://bit.ly/aJf2q6 #

RT @adamsbaldwin: "Government Wants ISPs to Record Browsing History…" | That's the Australian government, though. Not the US. #

Are the Feds and BP conspiring to prevent the media from recording the full impact of the oil spill? http://bit.ly/aa4ri6 #

RT @BryanPick: Why is the firing squad controversial? | Because it's icky and messy. We like our executions clean. #

FCC votes to regulate broadband service like a telecom. Is there ANYTHING these people don't want to control? http://bit.ly/bwEBFP #

If Michael Jordan brings back the Hitler mustache, it will be the most stupendous achievement of the 21st century. http://bit.ly/9tUS2A #

White House wants the senate to pass Cap & Trade in lame duck session, so no one has to face a tough vote before it. http://bit.ly/94CHzB #

Inspections for fire extinguishers take precedence over stopping the oil from reaching shore – http://www.qando.net/?p=8795 #

High court: Texts on government/employer gear not private http://usat.me?38908876

That's why I never use them. #

New 'morning after' pill approved by FDA is good for give days. Yay for unprotected sex! http://usat.me?38912476 #

Is it becoming clearer to everyone why we don't elect senators to the White House? #


Quote of the day – unclenched fist edition

I have to say, the “unclenched fist” diplomacy is just working out swimmingly with Iran. From a speech Iranian president Ahmadinejad gave on Thursday:

“It is God-given that all the anti-human plans in the world, and all the crimes and bloodshed, are being carried out under U.S. government supervision, but that the demand [to stop them] comes only from our nation… This move of theirs [apparently a reference to calls by President Obama to support the Iranian protest movement] forces us to adopt yet another international mission, because today the most brutal dictatorship is being implemented against the American nation, which is subject to the worst suffocation – the press is not free to depict the crimes of Israel and America, nor can demonstrations in response to these crimes be held freely…

“I hereby announce that from this point forward, one of the Iranian nation’s main aspirations will be to deliver the American people from [its] undemocratic and bullying government.”

Thank goodness someone is going to help us in that regard /sarc.

Your guess is as good as mine as to how he plans on accomplishing that but his take on Jews remains about the same as when we had a clenched fist.

“…Sixty years ago, they [i.e. the West] gathered the filthiest and greatest of criminals, who [only] appear to be human [i.e. the Jews] from all the corners of the earth, organized and armed them – on artificial and false pretexts, fabricating information and inventing stories [hinting at the Holocaust]. They gave [the Jews] propaganda and military backing so that they would occupy the lands of Palestine and uproot the Palestinian nation…”

Rhetoric says, at least to me, that the Islamists are warming up to another run at Israel sometime in the not to distant future.

~McQ

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