Friday, August 14, 2009

Obamacare & the great 'prevention" myth

Washington Post - Charles Krauthammer

In the 48 hours of June 15-16, President Obama lost the health-care debate. First, a letter from the Congressional Budget Office to Sen. Edward Kennedy reported that his health committee's reform bill would add $1 trillion in debt over the next decade. Then the CBO reported that the other Senate bill, being written by the Finance Committee, would add $1.6 trillion. The central contradiction of Obamacare was fatally exposed: From his first address to Congress, Obama insisted on the dire need for restructuring the health-care system because out-of-control costs were bankrupting the Treasury and wrecking the U.S. economy -- yet the Democrats' plans would make the problem worse.

Accordingly, Democrats have trotted out various tax proposals to close the gap. Obama's idea of limits on charitable and mortgage-interest deductions went nowhere. As did the House's income tax surcharge on millionaires. And Obama dare not tax employer-provided health insurance because of his campaign pledge of no middle-class tax hikes.

Desperation time. What do you do? Sprinkle fairy dust on every health-care plan, and present your deus ex machina: prevention. [...]


  1. You live in Israel. I am wondering, do you or any of your family members ever use the free health care there?

    My brother pays $1500 a month for health insurance with a 5k per family member per year deductible.

    We pay $700 per month for a plan that has a 10k per family member per year deductible.

    Both plans only pay $50k for a liver transplant and limit coverage for all sorts of other illnesses (we looked at the liver transplant because of a congenital problem in the family).

    We are not covered for prescription drugs or protheses, dentists, eye care, allergy testing, genetic testing for our congenital liver disorder, physical therapy and rehabilitation and many other health needs.

    My husband had a stroke 14 years ago and his rehabilitative therapy was not covered.

    Of course we cannot switch plans now either because of the "pre-existing" condition clause.

    Did I mention that maternity also is not covered? Nor is the first 30 days of a baby's life. That is another $500 per month and it must be paid for 12 months before the pregnancy is confirmed in order to be covered.

    We went without maternity coverage and paid cash for prenatal care and delivery. It was taking a chance because the baby was not covered for thirty days. It cost half as much to pay cash for the delivery than to pay the premium for the required time.

    My sister is a government employee.
    She left a job in private industry to make half as much as a government employee because she has a congenital heart problem and the gov't plan is the only insurance does not exclude her health issues as a pre-existing condition.

    She cannot go without insurance, she will not get treatment but no private insurance plan will cover her heart condition or anything that they decide are complications from it.

    So, for my sister, the only choice was to stay on disability so she could get Medicaid or to take a gov't job so she could get the same Federal plan that the President would like to offer to all Americans.

    I wish I could be covered by my sister's plan. Right now, if I have to go to the doctor, I have to put it on my credit card and make payments. Unless we are direly ill, we try to look it up in the internet and self treat.

    This is not exactly a desirable situation. Both my husband and I are post graduate educated professionals, who have health insurance coverage. We would hope for better than "cookbooking" our own medical care.

    My biggest mistake was relinquishing my British citizenship. At least I could have gone to England for anything major.

    My husband recently realized that his mother has Canadian citizenship and therefore he does also. This is great news because it means that he can drive into Canada for medical care.

    Now, if you don't mind, back to Israel. Do you ever use the free medical care in Israel?

    Is it better than nothing?

  2. I don't see how there could be any deficit as a result of having a national single-payer health insurance, like every other industrialized nation (all of whom have GREATER life expectancies and LOWER infant mortality rates than we do, by the way). Right now my family is paying over US$20,000 a year for insurance, at least half of which is profit, dividends for shareholders, and outrageous executive pay and bonuses. Which means when you cut the "for-profit" part out of the bill, it would go down by half. Then it would raise slightly to cover insurance for the currently uninusred (say, 10-20%), which still leaves me paying way LESS than I'm paying right now. So where does the deficit come from? The "scare tactic" math just doesn't add up.

  3. Ahavah Gayle wrote:

    Which means when you cut the "for-profit" part out of the bill, it would go down by half. Then it would raise slightly to cover insurance for the currently uninusred (say, 10-20%), which still leaves me paying way LESS than I'm paying right now. So where does the deficit come from? The "scare tactic" math just doesn't add up.
    I agree that health insurance is a horrible problem. But that doesn't mean that any solution is better than the present system.

    Your assertion that if the government runs the program that it would save 50% is wishful thinking. Just as the fantasy addressed by Charles Krauthammer that if more money would be spent for prevention that expenses would drop. The government's own calculations is that this program will add significantly to the national debt. In fact Obama's main problem is to raise enough extra taxes to cover this added expense so that there won't be an increase the national debt. The program itself is not a free lunch.

  4. FYI
    Israeli health care is not free. If you are employed your employer is supposed to pay for your basic coverage, otherwise you must pay for it yourself which runs NIS 140 per month.

    This does not cover specialists, dental or the like. Those are on more expensive(much more expensive) plans which your employer will not pay for. If you want that coverage you must pay it yourself.

    Also on all Israeli health insurance there are substantial co-pays.

    The Bluecross/Blueshield that I had in the US when I was working as a Mashgiach was a much better plan than anything I can get here. That was $30 a month taken out of my paycheck. It covered dental and specialists as well as general care with only a $1000 yearly deductible and $10 co-pay on prescriptions. I would rather have that plan again.

    Many Israelis, espcecially in the Yeshiva world, simply have no medical coverage, as they are not employed and have a hard enough time making ends meet that the "luxury" of having health insurance is simply not an option.

    I don't know about Canada but having friends and family in the UK, it is the same deal there.

  5. Recipients and PublicityAugust 16, 2009 at 8:54 PM

    The fascinating part of the present health care debate in the US is that no-one mentions the POSITIVE that 4/5ths of America's 300+ million population DOES have health insurance of one sort or another!

    The US has the best doctors (who come from all over the world) and facilities (that welcomes the elite from all over the world), while so much NEGATIVE attention is foucused on the so-called "49 million" who supposedly do "not have" coverage (it's not true, they can and are seen, by law, going through ANY hospital emergency room anywhere) and many of this number are illegal immmigrants who come from Mexico and places where criminals kill them at will when they are healthy (never mind "health care).

    So whil tendinf to a vast and sophisticated population is undwieeldy, it is not wise to go for a Russian roulette strategy whereby one never knows when the other shoe will drop and there'll be the straw that breaks the camel's back (pardon the mixed metaphors) and the US, which is already broke will go defunct entirely, a prospect that no one considers that could happen if the country breaks up and implodes, as did the former USSR or Yugoslavia leaving impoverished encalves ("fkae mini-states) to fend for themnsslsves while the richer parst of the country will take of their own and themselves. This is not far-fetched.

    At any rate, the insurance companies have won the wars long ago when they introduced the HMO system in the USA that allowed insurance compnay beurocrats to decide the course of one's treatment and classing doctors into either "primary care" gate-keepers responsible for managing patients and costs and then there are the specialists wwho have to acacept what the insurance companies are willing to pay.

    This has reulted in two serious things: (1) Less good doctors and as many potentially good ones simply avoid entering the feild or decide leave it, and (2) Once a doctor becomes accomplished he REFUSES to take ANY insusrance knowing that his services are in full demand. Yes his office will out insurance forms for you and even file them, but this type of doctor demands the full payment for his services as he determines them to be and not what he is told. This has happened already with many top doctors in the big cities.

    What the Obama people are aiming to do is not break down EVERYTHING and arrive at a sitaution where you willl have a system that is like in Cuba or the former USSR where the traditional brainy doctor will not be found but rather all sorts of lower level hacks and plumbers who will basically be glorified nurses with the title "doctors" and it has already started to happen on its own with insurance compaanies not reimbursing doctors enough as they would like and in turn the new cadre of "physicians assistants" has arisen that do the doctors work in hospitals and in private practices.

    With people being highly-informed and having access to information on the INternet, they will alwys look for cures and panceas that are not paid for by either pricvate insurnace or the government and will be forced to scrounge up the money to pay, even in Canad people pay when they want quicker and better service.

    Israel is a different story. It is the land of the Jews with many, many smart and idealistic people. Distances are not a problem, anyone can get to a nearby hospital or doctor. Many good doctors make aliya from all parts of the world giving Israel a unique pool of talent. Doctors do not have the aspirations of their associates in the USA, but they are just as or even more capable.

    You can't compare a tiny land with 6 million upwardly mobile Jews the size of Rhode Island with concentrated servives and functions to a massive country like the USA with 300+ million people from vastly different socio-economic and ethnic backgrounds spread over a sprawling continent.

  6. Recipients and PublicityAugust 16, 2009 at 9:31 PM

    Typo, my above post should say: "...What the Obama people are aiming to do is to break down EVERYTHING..."

  7. So let me tell you something, coming as I do from a country where the public system controls everything and the option to purchase private health care for essential services is illegal.

    The issue of preventative care is a red herring. It's not the main problem at all. The issue is the cost of healthcare and the sense of self-responsibility that goes along with it.

    Under a "Free" (ie it's in the taxes so people think it's free because they don't actually pay directly to see the doctor or use the hospital) system, you will see costs skyrocket. Why?

    1) If Hussein Obama decides to make government controlled health care available to whoever needs it, most private companies will dump their private health insurer and tell their employees to call 1-800-OBAMA for coverage. Far from 49 million people eligible for this new plan, it'll be more like 149 million people.

    2) Once health care is "free" there is no incentive to use it responsibly. Add to this the pent up frustration of the average American health consumer who is afraid to go to the doctor because of what it'll cost. Now imagine what will happen. Probably what happens in Canada. Do you know how many times a week I hear the words "I know it's just a cold but I wanted to come in and get it checked out." Or the guy in the ER I saw the other day who had fallen off his bike and gotten a bunch of scapes on his legs. Instead of going home and taking a bath, he came to the ER to get the nurses to clean it for him. At least once a month I see a patient in the ER who has come in to have his earway syringed out!

    3) Preventative health care? Hah! Private insurance is the best incentive to preventative health care. Americans know that it'll cost you big bucks to fix the problems that overeating, underexercising and smoking cause, yet they still do all three. Now imagine if there was no direct cost? People who have access to free health care stop taking care of themselves because they expect the free system to take care of their mistakes and fix them for them.

    Bottom line: the only reason Canada can afford such an expensive, oversized and inefficient national health care system is because we have no real army to speak of. We let America do all the defending for us.
    Unfortunately, Obama has a choice:
    1) Gut the army to pay for his health care plans.
    2) Raise taxes 100% to pay for them.
    Otherwise he will be bankrupting his country.

  8. Mekubal: $30 a month out of pocket is about $360 a year, vs. $20,000 a year for a typical crappy HMO plus dental, vision, etc. I don't know when you lived in the US but there is no such thing as $30 a month health insurance here.

  9. RAP says "The US has the best doctors (who come from all over the world) and facilities (that welcomes the elite from all over the world)."

    This is merely propaganda. If you look up the CIA factbook you will see that the US ranks #30 in life expectancy and #46 in infant survival.

    Statistics are very objective. The US outcomes stink in comparison to every other "first world" country.

    What is true is that the most technologically sophisticated health care in the world is available in the US.....for those who can pay for it. This is why the very best hospitals are full of the world's wealthy, rather than ordinary Americans.

    While some of you might be unhappy with the health care system in England or Israel, the fact remains that you are more likely to have your baby live to celebrate a first birthday in both countries, and you're more likely life longer than if you were in the U.S.

  10. Recipients and PublicityAugust 17, 2009 at 5:56 AM

    Bright Eyes says: "This is merely propaganda."

    RaP: By who? It is merely a point of view, and it's not advocating anyon'e "propaganda".

    "If you look up the CIA factbook you will see that the US ranks #30 in life expectancy and #46 in infant survival."

    RaP: This has nothing to do with the fact that the USA has the absolute best doctors in the world in quantity and in qaulity. These doctors are concentrated in the biggest cities and they do not run around the USA looking for people to cure and the poorer people do not know and cannot get to the good doctors, but the fact remains that the USA has the best and the largest numbers of top doctors in any field by far. They come from all over the world to be based in the USA. Is that "propaganda" too? By the way, since when do antiestablishmentarians like you rely on the CIA for their "facts"?

    "Statistics are very objective. The US outcomes stink in comparison to every other "first world" country."

    RaP: The USA is marked by a very high class top level elite while the general population may be below what the elite gets. But even the poorest US citizens benefit greatly. The other first world countries do not have the percentage of third world ethnicities like African-Americans and Latinos that the USA has, so get real. And we are talking about what the average US Jew can get in terms of medical insurance and help and for them it's what the elite in the country get not what Blacks in ghettos don't get. It's a complex picture.


    RaP: Wikipedia is not neutral, more pro-leftist than anything, and for the USA one must differentiate between different ethnicities, that's just the reality. More male Blacks are in jails and more Black females are unwed mothers, etc, so get your p's and q's straight.

    "What is true is that the most technologically sophisticated health care in the world is available in the US.....for those who can pay for it."

    RaP: And even for most who can't. Just go to any emergency room and you will see it packed with minority ethnicities getting the best care as they are admitted like anyone else. Minorities tend to live in the same big cities as the elites so they get access to the same doctors and hospitals de facto. ...

  11. Recipients and PublicityAugust 17, 2009 at 5:56 AM

    Bright Eyes says: "This is why the very best hospitals are full of the world's wealthy, rather than ordinary Americans."

    RaP: Baloney! When ANY American, White, Black, Yellow, Red or Brown, gets sick and is taken to a hospital they will and must be treated once in the emergency room. You are advocating communism and it will not work. The wealthy are usually more sophisticated and in fact most doctors are in that class themselves, so don't knock them. Remove the wealthy and destroy their incomes and what you have will be Nigeria or Egypt where there is no insurance and anyone can go to a hosptial too to get "operated on" by butchers and quacks.

    "While some of you might be unhappy with the health care system in England or Israel, the fact remains that you are more likely to have your baby live to celebrate a first birthday in both countries, and you're more likely life longer than if you were in the U.S."

    RaP: Sheer lies. When was the last time you heard of Jewish babies or the babies or responsible parents dying in hospitals? It's maybe one in a hundred thousand. On the other hand mothers who are drug addicts and prostitutes or sexually active teens and young women with multiple partners many suffering from various STDs and have taken no prenatal precautions will lose more of their babies, so again, keep in mind which population group you wish to focus on. The USA is FAR LESS a homogenous nation like Britain or Israel. Most British are white Anglo-Saxons and most Israelis are either European Ashkenazim or Middle Eastern Sefardim, two distinct groups unlkike the USA that has dozens of still struggling ethnicities, Black, Latino, Native American, Chinese etc who do not understand health care needs and ideas. Many of the Black areas of the South are more akin to Africa than to a Western society. And the US's Latinos are more like Central and South Americans than Europeans. Etc. The USA is not just a country, it's a CONTINENT with different population groups so aggregates and averages do not give the full picture at all times and can even distort the truth.

  12. Recipients and PublicityAugust 17, 2009 at 6:08 AM

    Ahavah Gayle says: "vs. $20,000 a year for a typical crappy HMO plus dental, vision, etc."

    True. But here are two ways to resolve it:

    (1) If you (and your spouse, if you are married) are making a decent salary, then you will find ways to pay for this too, and even find better plans, keep shopping around, they are out there.

    (2) If you are in a bind then you have no choice and learn from the poor African-Americans and the Chasidim with large families, become eligible for MEDICAID (if you are 63 and have worked enough years you are eligible for MEDICARE) that works for tens of millions of US citizens. Even without MEDICAID there are now many Child Health Plus plans for children under the age of 21 so if you have children you can have your kids covered under these state and government plans. There is always a plan that can be fitted to the needs of the person, and that is why there are free community organizations in every frum Jewish community that can help any Jew and client obtain the right state medical help, as well as food stamps, section eight for housing and af ew other programs that help families in genuine need. The USA to its eternal credit has been bailing out needy individuals and families long before it was bailing out corporations. (Obama would like to stop that and send the money to Africa instead as "reparations" for slavery, the real goal of his diabolical "reforms" and "changes"!!!)

    God Bless America, and may Africa continue under the spell of Noah!!

  13. Ahavah Gayle said...
    Mekubal: $30 a month out of pocket is about $360 a year, vs. $20,000 a year for a typical crappy HMO plus dental, vision, etc. I don't know when you lived in the US but there is no such thing as $30 a month health insurance here.

    I held that Job from 2000-20004. BlueCross/BlueSheild PPO was the plan offered by the company, at $30per month($15 per adult and $5per child), I had no children at the time... so for my wife and I it was $30 per month.

  14. Anyone who thinks that everyone in the US who walks into an emergency gets treated has never tried to get treated without insurance.

    Besides, RaP, if you're right, then the fact that the US has all of these "third world ethnicities like African-Americans and Latinos that the USA has" shouldn't matter. They all get treated, according to you.

    I trusted the CIA factbook because it's fair to assume that our own government's intelligence agency would do its best to pain ta rosy picture of the U.S. system, rather than a negative one.

    You say "baloney" and "nonsense", but back it up with rhetoric instead of statistics.

    Unless you are trying to say that they genetically inferior stock.

    France and England have huge minority populations. Why would Moroccan or Black populations in France have better health outcomes than their cousins in the U.S.?

    The argument that minority populations in the US skew the health statistics gets very questionable when you look at cancer rates and bipolar disorder rates amongst Hungarian Jews that are high in the US, but not high amongst their cousins in France and England. Johns Hopkins is studying this very question.

    I'm jealous of you that you actually believe that everyone who walks into an emergency room gets care.

    Calling it communism is silly. I'm not exactly advocating gov't controlling all industry and a total sharing of resources! I'm just talking about healthcare.

    It's not like England, France, Norway, Sweden, Denmark, Italy, Israel, and Canada are communist just because they have a national healthcare plan.

    If you have other statistics that show how great the U.S. healthcare is, produce them. While you're at it, you could explain why there is so much medical tourism from the US to Mexico, Canada, and Cuba, if everyone can get treated by just walking into an emergency room.

  15. Recipients and PublicityAugust 17, 2009 at 9:07 PM

    Beware the Counterrevolution (Andrew Thomas. August 16, 2009 in the American Thinker): "The left is already telegraphing its strategy to discredit the town hall movement. Conservatives must wise up and use a little jiujitsu of our own.

    It is important to note from the start that the struggle between liberty and socialism will never end, at least not in our lifetimes. If by chance it does, it will be because evil has triumphed. As long as people are free to make their own choices, some of those choices will always be for self-destruction or slavery (moral masochism)...

    ...the socialist left keeps returning. It is relentless. When their evil intent is revealed, the leftists retreat and then re-package it in different wrapping paper. Socialized medicine becomes Hillarycare becomes ObamaCare. Healthcare is a right for everyone, they say. Who would dare oppose that? Environmentalism becomes global warming becomes climate change. Who could be against saving the planet? The weakness of a free people is exploited.

    The problem for these strategies is that once people have had a chance to examine the packages, they are discovering that they are Trojan horses. They do not save the planet nor provide quality healthcare for all Americans. Their sole purpose is to dramatically expand the power of the government over its citizens, providing the potential for complete enslavement.

    Americans are finally waking up to this fact, albeit almost too late. They are angry. They have been misled. Surprising the socialist left with their ferocity, they are storming into town hall meetings and confronting their dishonest legislative representatives. Hypocrisy is being exposed. We have taken the high ground and are on the offensive. Is it time to high-five each other and celebrate our victory?

    ...They are changing the face of America surreptitiously through an unelected and completely uncontrolled group of leftist radicals (including an avowed Communist) known as "Czars". Congress has been relegated to the status of "useful idiots". The government commands the powerful thuggish shadow armies of ACORN and SEIU, with the intent of forcibly drafting millions of our kids, brainwashing them, and inducting them into a third shadow army, AmeriCorps.

    Do you really believe that the next elections in 2010 and particularly 2012 will be the solution to the current socialist infestation? Do you think that people who are as addicted to power as Obama, Emmanuel, and Axelrod will passively accept their ouster in a fair general election? After fighting the good fight, will they gracefully withdraw from power?

    This administration currently controls the census, which can initiate creation of additional congressional districts in liberal areas of the country based on their populations as counted by leftist community organizers. The left dominates election committees and polling volunteers. If they decide to sabotage voting machines or vote tabulation software or servers, who will provide the oversight to prevent them from doing so? They run the largest organized voter fraud organization in the world (except for perhaps Iran) a.k.a. ACORN. Who knows what "October surprises" they have planned? Will we see the New Black Panther Party more actively menacing voters at the polls, since the Obama administration refuses to prosecute this voter intimidation?

    Leftists do not see election fraud or other dirty tactics as illegal, immoral, or unethical. This is because the socialist agenda is for the good of the nation, a noble cause to promote and protect at any cost. In other words, the ends justify the means. In the final analysis, it is difficult to predict what they are capable of. The rules don't apply to them. We can only study the actions of other socialist leaders such as Lenin, Stalin, Castro, and Chavez, and make assumptions...."

  16. Recipients and PublicityAugust 17, 2009 at 9:15 PM

    "England, France, Norway, Sweden, Denmark, Italy, Israel, and Canada" are by now social democratic countries which is just a polite political science euphemism for what is bluntly called Socialism as derived from Marxism and not that far removed from Communist theory and practice in the former Eastern European communist bloc. The health care systems in many Eastern European countries, both under communism and continuing today, was and is not far different in final outcomes compared to their Western European neighbors, as a reflection of their higher level Western cultural standards as compared to societies stemming from from long-ago Ghana or present-day Mexico. This is so obvious, and not "rhetoric", that it's surprising you would even fight it.

  17. Recipients and PublicityAugust 17, 2009 at 9:33 PM

    "While you're at it, you could explain why there is so much medical tourism from the US to Mexico, Canada, and Cuba,"

    Sure, Americans love to travel, even when they are on their deathbeds!

    With Obama's "end of life" counseling he will be saving them the trips! Free government-sponsored cremations can't be far behind, like US servicemen who get money for their burial plots.

    Oh, I can't wait to hear how good the Mexican and Cuban doctors are. They must get a lot practice from all the deadly gang warfare, drug taking and pimping (Mexico) and the torturing political prisoners (Cuba) and imprisonment of dissenters, but methinks all those tens of millions of Mexicans desperate to make it into the "bad ol'" USA and the hundreds of thousands of Cuban boat people (moany of them sick people that Castro cast off into the sea like the cruel barbarian that he is) and the millions who have fled to Florida and would flee if they could from Cuba tell us by voting with their feet (not to mention all the other tens of millions of people from all those wonderful countries that hate the USA but love to come to live in it) that they prefer the good ol' Uncle Sam's USA's doctors and hospitals broken system to any of the supposed "superlatives" they could benefit from in either Mexico or Cuba or wherever. Same goes for Canada, there is more traffic going south by Canadians seeking relief from their clogged up system than Americans going north for the favor of waiting in line for months to be seen by a state paid huckster doctor in Canada (who do you think will want to be doctors once the government takes over? Answer: the guys who used to be car mechanics and plumbers will be "doctors" while the ones who used to want to be doctors will be trying to work for multinational corporations that can pay them the millions they want and deserve for their brain power that most others simply were not endowed with for highly skilled work.)

    You think the CIA would argue with what I just stated?

  18. RaP is very good at countering statistics with blather.

    There's an old saying in the legal profession: If you're right, bang on the facts. If you're wrong, bang on the table.

    Your rhetoric still does not explain why several dozen countries who all spend less on healthcare than the US (both as total dollar amounts and per capita amounts) have better health and survival statistics than the U.S.

    The fear-mongering of trying to paint the picture that Israel is almost like Russia, because Socialism is so terribly close to Communism, would be met with fits laughter by the 1.5 million Russians who eagerly fled their homeland for a better life in Israel.

    Your statement that medical tourism exists because Americans like to travel is simply a stupid and insensitive thing to say.

    I know a nice upper middle class attorney in Los Angeles who needed to have 3 teeth capped. The price in L.A. was $2,800 per tooth, for $8,400. In Tijuana, he was treated by a US Board certified Dentist for $800 per tooth. So, he saved $6,000 by driving 2 hours and doing it in Mexico. If you've ever been to Tijuana, you would realize quickly that very few people consider that to be a hot vacation destination.

    I knew someone else who injured himself playing golf in Florida and dislocated his shoulder, tearing something important up there. In Florida, in the emergency room, with a US insurance plan offered by one of the great competitive US based insurance companies, all they would give him without $20K up front was painkillers. He didn't have the $20K. Luckily for him, he was born in Canada, so he got on a plane and few to Montreal to get treated. Price: $0. Believe me, with a dislocated shoulder, he didn't feel like traveling to Canada.

    I know someone else whose father was diagnosed with Leukemia. He's insured. Insurance was fighting the chemotherapy. Fearing for his life, he returned to France, where he's from, and got treated. People who are dying from cancer generally don't book European vacations.

    Anyway, it's clear that you have no statistics to back up any of the nonsense you are spewing, and this simply proves that you are wrong. Healthcare is not a philosophical issue. It's a black and white numbers issue. Costs are costs. Average life expectancy is average life expectancy. Infant survival to the first year after a live birth is the same concept everywhere.

  19. Recipients and PublicityAugust 18, 2009 at 9:42 PM

    By the way, I just saw these two relevant stories on the Drudge Report. This what you'll get in the USA, and much worse (the US has a higher population than the UK and Canada combined), under so called "ObamaCare[less]":

    UK SYSTEM: Woman gives birth on pavement 'after being refused ambulance' (UK Daily Mail, 17th August 2009): "A young mother gave birth on a pavement outside a hospital after she was told to make her own way there.

    Mother-of-three Carmen Blake called her midwife to ask for an ambulance when she went into labour unexpectedly with her fourth child.

    But the 27-year-old claims she was refused an ambulance and told to walk the 100m from her house in Leicester to the city's nearby Royal Infirmary.

    Her daughter Mariah was delivered on a pavement outside the hospital by a passer-by, just before ambulance crews arrived.

    Today the Trust that runs the hospital said it would look into any complaint made about the advice and care the 27-year-old received.

    Ms Blake said she started going into labour at about 7.15am on Sunday, August 2.

    She said: "I phoned up the Royal Infirmary, it's just across the road, and they said to go into a hot bath, and then to make my way over there......"


    CANADIAN SYSTEM: Thousands of surgeries may be cut in Vancouver. (Vancouver Sun. August 10, 2009): "VANCOUVER — Vancouver patients needing neurosurgery, treatment for vascular diseases and other medically necessary procedures can expect to wait longer for care, NDP health critic Adrian Dix said Monday.

    Dix said a Vancouver Coastal Health Authority document shows it is considering chopping more than 6,000 surgeries in an effort to make up for a dramatic budgetary shortfall that could reach $200 million.

    “This hasn’t been announced by the health authority … but these cuts are coming,” Dix said, citing figures gleaned from a leaked executive summary of “proposed VCH surgical reductions.”

    The health authority confirmed the document is genuine, but said it represents ideas only.

    “It is a planning document. It has not been approved or implemented,” said spokeswoman Anna Marie D’Angelo.

    Dr. Brian Brodie, president of the BC Medical Association, called the proposed surgical cuts “a nightmare.”

    “Why would you begin your cost-cutting measures on medically necessary surgery? I just can’t think of a worse place,” Brodie said......."

  20. Recipients and PublicityAugust 18, 2009 at 9:55 PM

    Here's a clear sign that the USA is on the slippery slope of becoming just another Third World country for most of its citizens, as ObabaCare[less] will force most intelligent people out of the business of being doctors and seeking employment and wealth in the business world where it's kosher to make lots of money based on your brains, unlike a communistic system like Cuba's or Vietnam's where the state "owns" everyone and everyone is enslaved to be told what do whether they like it or not. Read on and see what you make of it: Doctor shortage looms as primary care loses its pull (USA Today, 8/17/2009): "...Lower pay, more administrative headaches and a host of other reasons have turned doctors away from family medicine, presumed to be the frontline for preventive-care programs that can help reduce health care costs, yet need is increasing as the population ages...The number of U.S. medical school students going into primary care has dropped 51.8% since 1997, according to the American Academy of Family Physicians (AAFP)...Considering it takes 10 to 11 years to educate a doctor, the drying up of the pipeline is a big concern to health-care experts. The AAFP is predicting a shortage of 40,000 family physicians in 2020, when the demand is expected to spike. The U.S. health care system has about 100,000 family physicians and will need 139,531 in 10 years. The current environment is attracting only half the number needed to meet the demand.

    At the heart of the rising demands on primary-care physicians will be the 78 million Baby Boomers born from 1946 to 1964, who begin to turn 65 in 2011 and will require increasing medical care, and the current group of underserved patients...

    Finding a doctor will get increasingly difficult, waits for appointments will grow longer, and more sick people will turn to crowded emergency rooms, says Ted Epperly, president of the AAFP, an association that represents more than 93,000 physicians. Or, if a patient goes to a doctor's office, he might not be treated by his doctor: One way overwhelmed family physicians have been dealing with patients is to have office visits overseen by a nurse practitioner or a physician's assistant, some of whom can dispense certain prescriptions and recommend specialists, Epperly says.

    "At the time we need family-care physicians the most, we are producing the least," Epperly says. "The nation's medical schools are failing to produce a workforce that is essential to caring for America's communities."..."

    It's not gonna be a lot of fun, that's for sure!

  21. Recipients and PublicityAugust 19, 2009 at 8:19 AM

    "Bright Eyes" (sounding more like blinkered or blindfolded eyes here) is really making me laugh. He/she doesn't even get it when I make a pretty good darned joke (Q: Why do sick Americans go overseas for medical care? A: Because Americans love to travel, even when they are on their death beds -- something that Jay Leno or Jackie Mason would get loads of laughs for, but brittle Bright Eyes wants to take the moral high ground and act outraged.)

    You know, I would be glad to spout statistics, but first let us agree that it is also perfectly legitimate to use logic, reason and refernces to known facts and realities (not "rhetoric" and "propaganda" as you sneer at me and deride my solid presentations and as you imagine it to be in your limited and selective lexicon). Anyone anywhere can start screaming about "statistics" (scientists use statistics all the time to disprove religion and classical morality and to deny God's existence, so what does that prove?) but that does not detract from a common sense and logical debate first and foremost based on TRUTH and REALITY (one does not need statistics to agree upon the truth. While statistics may help to support some FACTS, they are not a pre-requisite for arriving at the TRUTH. Socrates, Plato and Aristotle did NOT need "statistics" to arrive at their universally philosophical truths and WISDOM (yesh chochma bagoyim), nor did the Tannaim of the Mishna and the Amoraim of the Gemora need "statistics" to arrive at their statements which were based on ABSOLUTE KNOWLEDGE of the TRUTH of the Torah in all its depth and intracacies. So sure, we can have chats laced with statistics if you like, like writing a term paper for your biology teacher, but we are older and wiser than that, so that my preference is for a maturer debate that assumes that one can deal with higher order intellectual, philosophic, notions and ideas without babyish props suitable for high school and college kids.

    I can't be as "wrong" as Bright Eyes is trying to depict, since after all the mainstraem media is publishing plenty of articles that's in line with the arguments I am making so far.

    Take a look at this one from the Wall Street Journal (hope it's reliable enough for you): Obama and the Practice of Medicine
    Why is the president convinced so many doctors and patients are making irrational decisions?
    (August 14, 2009) written by Dr. Scott Gottlieb, "Dr. Gottlieb, a former official at the Centers for Medicare and Medicaid Services, is a fellow at the American Enterprise Institute and a practicing internist. He's partner to a firm that invests in health-care companies.": "On the defensive because of an increasingly skeptical public, President Barack Obama has recently spoken extemporaneously about his health plan. In doing so, he has revealed his lack of understanding about aspects of medical practice and the reasons for rising health-care costs...Instead of addressing the distorted financial incentives that influence these kinds of routine tests and treatments, Mr. Obama's policies seek to directly regulate doctors and their decisions...Regulating medical decisions should not be the responsibility of a remote Washington bureaucracy. The only way to instill more reflection at the point of medical decision making is to give doctors and patients reasons to consider the cost of various options...Mr. Obama says as much as one-third of medical spending is wasted on services that provide little or no benefit. But closer scrutiny of these kinds of marginal medical decisions can't be imposed by government regulation. Cost consideration must be internalized at the point of care by patients and doctors with a stake in the price, as well as the outcome."

    Take it up with Dr. Gottlieb will you and stop being such a blinkered and blindfolded knee-jerk supporter of Barack Hussein Obama.

  22. RaP -- I apologize for being so harsh and judgmental. Sorry I missed your joke.

    The person you quote in the WSJ article is a "partner to a firm that invests in health-care companies"

    For him, life is grand just the way it is. He is so worried about government tying the hands of doctors and dictating treatment, yet it doesn't seem to bother him that the insurance companies already do this.

    The earlier article you referenced stated ""...Lower pay, more administrative headaches and a host of other reasons have turned doctors away from family medicine,"

    The "lower pay" problem comes largely from the fact that the for-profit insurance companies really don't like to pay for medical treatments. This in turn has forced many doctors into saying they won't accept insurance and that the patient needs to pay and seek reimbursement themselves.

  23. Recipients and PublicityAugust 20, 2009 at 9:20 AM

    Just heard of a case today of a very choshuve Yid, has a big Orthodox, he is Modern Orthodox and a life-long Religiois Zionist who gave his life for building the state of Israel and who for the last twenty five years lived primarily in Israel who was diagnosed with a brain tumor about six months ago in Israel and was refused an MRI in Israel, because, guess why, he was 89 years old (yes eighty nine) he was fit as a fiddle until then and lucid, but someone in Israel's kupat cholim system (doctors or beurocrats or both) obviously decided that at 89, he was terminally ill, wasn't worth it, and an MRI with subsequent surgery or radiation or chemo would be "wasted" on him.

    This is exactly the kind of thing that ALL seniors in the USA can expect under ObamaCare[less] and why so many people are fearful that Obama's cuts of MEDICARE for seniors who paid their social security dues and taxes, to go to younger people, many who have never paid enough or any taxes, who are mostly healthy and do not need care, so there is no logic either.

    So he was forced to come to the USA, he must have had dual-citizenship, and got the MRI and they started to treat him but he passed away before surgery, while he may have lived on had and MRI and ssurgery been performed right away in Israel. (I know, these are impossibly tough situations with unenviable tougher decisions, but this case got me thinking today.)

    Now can anyone please explain why denying an MRI to an 89 year old man, a solid citizen of the state, is a good decision? Would a 9 year old or 29 year old man have a better chance if they were given an MRI if they were found to have a brain tumor? Because it makes no difference how old a person is once they are diagnozed with a brain tumor since life will be tough and shortened for them no matter what. So to deny an 89 year old man an MRI in Israel, a devoted servant of the Jewish people and the Zionist cause yet, makes absolutely no sense on any grounds, be they medical, financial or moral. Yet this is what the Obama people want to rain down upon on America's elderly and disabaled with MEDICARE coverage, by slashing it, limiting it, and micro-managing it literally to death.

  24. Recipients and PublicityAugust 20, 2009 at 9:34 AM

    And here's proof-positive of what ObamaCare[less] plans of doing:

    Obama Throws His Grandmother under a Bus, Again (By Fred Dardick, Canada Free Press, August 18, 2009): "What’s the deal with Barack Obama selling out his own grandmother every chance he gets?

    In another example of Obama’s lousy attitude towards the woman that raised him since he was 10 years old, the New York Times this weekend recalled an interview in which he criticized his grandmother, Madelyn Durham, for electing to undergo hip replacement surgery despite being terminally ill:

    “I don’t know how much that hip replacement cost… (I don’t feel) society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model.”

    “I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill.”
    Apparently Mrs. Durham is exhibit #1 on how the no good elderly are heartlessly wasting the nation’s collective healthcare resources for their own selfish purposes, like wanting to walk.

    As a productive member of society, Mrs. Durham had every right to make her own decisions regarding healthcare, including a new hip if that is what she and her doctors saw fit. It is not our place, or anyone else’s for that matter, to be dictating to seniors at what time they no longer qualify for expensive healthcare procedures.
    The audacity for Obama to suggest that his own grandmother wasn’t worth a $20,000 hip replacement surgery at the end of her life is remarkable … Michelle Obama will spend more than that on hair and makeup this year alone!

    This latest criticism of Mrs. Durham is reminiscent of Obama’s highly touted March 2008 race speech where, in addition to his famous declaration “I can no more disown him (Rev. Wright) than I can disown the black community”, Obama described his grandmother as “a woman who once confessed her fear of black men who passed her on the street and who, on more than one occasion, has uttered racial or ethnic stereotypes that made me cringe.”

    Obama actually called his grandmother a racist in public, to the entire world! Now he points to her as a classic example of the elderly stealing valuable healthcare resources from the nation. Does Obama’s depravity towards Mrs. Durham know no end?
    I don’t know if it’s a race thing, or age thing, or what, but it makes me wonder, if Obama thinks so poorly of own grandmother, I can only imagine how little he feels for the rest of us."

  25. Recipients and PublicityAugust 20, 2009 at 10:29 AM

    Bright Eyes said: "The person you quote in the WSJ article is a "partner to a firm that invests in health-care companies"

    But take a look at this article that says the opposite of what you say, that it is the Obama people that are shmeering others big time to get their way:

    Firms with Obama ties profit from health push (Associated Press, Aug 19 '09): "WASHINGTON – President Barack Obama's push for a national health care overhaul is providing a financial windfall in the election offseason to Democratic consulting firms that are closely connected to the president and two top advisers.

    Coalitions of interest groups running at least $24 million in pro-overhaul ads hired GMMB, which worked for Obama's 2008 campaign and whose partners include a top Obama campaign strategist. They also hired AKPD Message and Media, which was founded by David Axelrod, a top adviser to Obama's campaign and now to the White House. AKPD did work for Obama's campaign, and Axelrod's son Michael and Obama's campaign manager David Plouffe work there.

    The firms were hired by Americans for Stable Quality Care and its predecessor, Healthy Economy Now. Each was formed by a coalition of interests with big stakes in health care policy, including the drug maker lobby PhRMA, the American Medical Association, the Service Employees International Union and Families USA, which calls itself "The Voice for Health Care Consumers."

    Their ads press for changes in health care policy. Healthy Economy Now made one of the same arguments that Obama does: that health care costs are delaying the country's economic recovery and that changes are needed if the economy is to rebound...

    A larger issue is a network of relationships and overlapping interests that resembles some seen in past administrations and could prove a problem as Obama tries to win the public over on health care and fulfill his promise to change the way Washington works, said Sheila Krumholz, executive director of the Center for Responsive Politics, a government watchdog group.

    "Even if these are obvious bedfellows and kind of standard PR maneuvers, it still stands to undercut Obama's credibility," Krumholz said. "The potential takeaway from the public is 'friends in cahoots to engineer a grass roots result.'"...

    AKPD and GMMB both proudly proclaim their connections to Obama on their Web sites.

    AKPD has a full page on Axelrod that includes pictures of Obama. In one photo, Obama hugs Plouffe on election night.

    "We are deeply honored to have been part of Barack Obama's historic campaign to change America and the world," GMMB says on its Web site. GMMB's partners include Jim Margolis, a senior strategist for Obama's presidential campaign.

    Both GMMB and AKPD also have worked for Democrats this year. The Democratic National Committee paid AKPD at least $106,000 for polling, media production, communication consulting and travel costs from February through April. The Democratic Congressional Campaign Committee paid GMMB roughly $75,000 from February through June for ads. And GMMB took in at least $9,000 this year from Senate leader Reid's political action committee for communications consulting."

  26. Recipients and PublicityAugust 20, 2009 at 11:33 AM

    Agudath Israel of America's opinion, as reported in Yeshiva World News, is worth taking note of for both the way it tries to tread a fine line and make nice politically but at the same time also make clear the obvious Orthodox and Halachic problems that some of the ObamaCare[less] plans would bring about:

    Agudath Israel Weighs In on Health Care Reform (August 19, 2009): "WASHINGTON, D.C. - Lauding the idea of universal health coverage but warning about the challenges that health care reform may pose in the realm of religious rights, Agudath Israel of America’s Washington Office director and counsel, Rabbi Abba Cohen, laid out his organization’s perspective in a letter addressed to President Barack Obama, and copied to Congressional leaders and Health and Human Services Secretary Kathleen Sebelius.

    The letter calls “universal coverage” a “worthy goal” and the fact that tens of millions of Americans reportedly have no health coverage “unacceptable.” At the same time, it expresses concern that the cost-cutting measures designed to achieve universal coverage could result in diminished medical options for patients, and might undermine the centrality of the patient-doctor relationship.

    Those concerns, according to Agudath Israel, must be considered in light of the fact that, for Orthodox Jews and millions of Americans of all faiths, “the preservation of life and the promotion of good health and well-being are religious imperatives.” This insight, writes Rabbi Cohen, “adds an important new dimension to the debate over health care policy” - a debate that has taken center stage in the public arena as legislation seeking to overhaul health care in the United States is being considered by Congress.

    The issue of religious rights, Rabbi Cohen writes, certainly bears impact on patient treatment. Agudath Israel is concerned that appropriate health care may not be provided in circumstances where “cost-benefit” analyses or judgments about “quality of life” may cause treatment to be denied; and asserts that treatment of the infirm must take into account patients’ religious convictions.

    Furthermore, the religious rights of health-care providers and private sector employers must also be respected, writes Rabbi Cohen. When medical personnel, for instance, are “called upon to perform medical procedures they consider religiously or morally objectionable” or “employers are told to provide coverage for such procedures,” Agudath Israel asserts, their rights should be safeguarded.

    Rabbi Chaim Dovid Zwiebel, Agudath Israel’s executive vice president, noted the unique contribution the organization’s letter makes to the ongoing national debate. “Discussion of the religious dimension of health care has been largely absent from the national dialogue,” he says. “In reality, matters of life and death cannot be measured solely in dollars and cents; they no less need to be considered through the prism of religion and morality.”

  27. RaP...this is all very interesting stuff.

    A lot of people are coming out against all of these things that have strangely already been in place for the last 40 years or so.

    I didn't see Agudath Israel saying that Medicare is a bad thing before, yet the gov't is pretty much proposing to make a Medicare-like plan available for people under 65 to purchase if they wish to.

    The centrality of the patient-doctor relationship is already affected by what private insurance companies are willing to pay for.

    So, why object now to a potential gov't plan on the basis that the plan might offer some of the same limitations that today's free market insurance/health care system already has? I don't understand why they did not object earlier against those companies who already impose these problems and restrictions.

    If, as you have claimed before, the US has such an enviable medical system in place already, and that system's success is measured at least in part by the better health and longevity of our senior citizens, then it follows that a lot of the credit for their receipt of proper healthcare must be due to the access provided by largest insurer of these people: Medicare.

    So, if Medicare is good for the older, then why object to offering it to younger people [for the actual cost of the insurance], if it's already producing what you consider to be good results? (and doing it with only 4% administrative costs, compared with well over 20% in private industry).

  28. Recipients and PublicityAugust 21, 2009 at 2:09 AM

    Bright Eyes, a lot of the MEDICARE system is run by private medical insurance companies since the government pushed them into the hands of the private insurance companies HMO's knowing that they are better equiped to handle medical issues because they are, after all, MEDICAL insurance companies. This has meant that those who chose this did not have to pay the 20% differential that normally rerquired another premium (over and above MEDICARE) from private insuranec companies.

    Same with MEDICAID, a lot of it, I do not know exact figures, is run through private medical insurance companies. Even if it's at threadbare system, the medical insurance companies that are commisioned to run a big part of MEDICAID and MEDICARE on behalf of the government know how to manage and cut costs without causing a social collapse and a revolution, yet you are assuming that if the government will hire unknown beurocrats (and we can assume that many will get jobs based on patronage, racial quotas and unknown factors) you are going to have high school dropouts who get government jobs telling doctors and educated patients what to do with their lives and with how to manage their health issues.

    You seem to think, and the Obama people argue like this too, that switching sophisticated health insurance company beuracracies with government beuracrats is the "same thing" when it's not because companies that are part of the private sector and are also answerable to stock holders have better educated and higher levels of operation than programs run out of dusty governmental offices run by party hacks and people who have been given jobs based on their loyalty to Obama and not to a medical insurance system

    There is much more, but you really need to get away from a superficial presentation of the serious matters before the USA's people.

    Very importantly, the practice of medicine, like the free enterprsie system in general, counts on top talent coming in because they can see great rewards, and if the Obama people have their way, it will in effect destroy the USA's medical structure, and all the trillions will be going to pay medical staff and facilities befitting a Cuba or a Egypt where getting treatment is like playing Russian roulette.

  29. RaP -- While you make some logical arguments, there are some areas that are still difficult to understand:

    If, as you say, a gov't option will dilute the quality of talent that will enter the medical system, then why are England, France, Japan and Germany so far ahead of the US in positive health outcomes?

    You state "companies that are part of the private sector and are also answerable to stock holders have better educated and higher levels of operation than programs run out of dusty governmental offices.." Being answerable to stockholders means that profit is the goal of the system, since this is what the stockholders demand. Why/How does an insurance system that is based on profit become inspired and expected to have better health outcomes?

    You've seen the President appoint quite a few Republicans for top jobs. Clearly he's making choices based on talent, and not politics. Are you saying that the Surgeon General is unqualified as a physician? What about Howard Dean, John Edwards, and other doctors who have advocated Obamas ideas and also happen to be in the government?

    Your statement of high school dropouts getting substantial government jobs is ludicrous. I've consulted w/the government on some of their hiring matters and can assure you that they hire people who are often come from industry and are quite intelligent and talented. They work in government jobs that sometimes pay less because of a sense of civic responsibility. But, you would be shocked at how high paying some government jobs are, and in many cases they pay better than in industry.

    The "sophisticated health insurance company bureaucracies" exist in order to produce profits for the insurance company by denying care that patients expect to receive. When the gov't outsources some of their administrative tasks to the private insurers, for a fee, they do so with the express instructions that the usual insurance company games of coverage denial not be played. This is why when they outsource it to the insurance companies, overhead remains at 4%. The other 22% that the insurance companies usually spend it 100% spent to avoid making medical payments.

    "the medical insurance companies that are commisioned to run a big part of MEDICAID and MEDICARE on behalf of the government know how to manage and cut costs without causing a social collapse and a revolution" If this were true, then we wouldn't be having the social collapse and revolution that are occurring right now. There would be no big health care debate because everything would be just fine right now. It isn't. The status quo is a failure.

    You should be blessed to be in great health so that you never have to experience just how disgraceful and cruel our insurance industry actually is, and how much they work against quality medical care.


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