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Broder Gets It – Sort Of February 11, 2007

Posted by Jim Satterfield in Health Care, Politics.
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David Broder has all too often lately seemed to not understand the mis-steps of the Bush Administration as well as I’d like, but overall is far less objectionable than others who are ideologically blinded to them. Today’s column calls them to task for their chicanery in what can only laughingly be called a budget. He does a good job of pointing out many of the games and misrepresentations in it. Where does he fall down?

When it comes to the health care cuts he has this to say:

Bush also has described, in blunt terms, the dismal financial prospects for Medicare — premiums will have to increase fivefold to sustain the program unless some way is found to curb health-care inflation. As a start on alleviating that crisis, Bush has proposed $66 billion in savings over the next five years, achieved mainly by trimming payments to providers and boosting premiums for the well-to-do.

Congressional Democrats are screaming even about these modest changes, but the problem is real. Bush would be in a stronger position to secure these savings if he were not pretending that he can balance the budget by 2012 while preserving all his tax cuts.

The emphasis is mine. What’s wrong with these “modest changes” in my mind? The fact that they depend on that old standby of shafting the providers is what bothers me. While it might seem that the small amount being cut shouldn’t make any difference remember that we’ve seen all of this before. The amounts currently being paid to health care providers is already too small. There are providers who won’t take Medicaid right now. If we take this path for Medicare we’re probably heading towards patients having the same problems that they currently have with Medicaid where it’s difficult to find providers who take it. This isn’t reform of the system, it’s just claiming to do something that has to be done because the effort of true reform seems to be beyond them.

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1. double-soup tuesday - February 12, 2007

The amounts currently being paid to health care providers is already too small. There are providers who won’t take Medicaid right now. If we take this path for Medicare we’re probably heading towards patients having the same problems that they currently have with Medicaid where it’s difficult to find providers who take it.

Uh, no. What we need to do is saturate the market with some H1-B doctors to reduce the cost and the arrogance of the US natives. Between the AMAs monopoly on certifications and pharma lobby, the American public is being screwed but good.

I think we can start by importing 50-100K Desis with medical degrees to clear out those waiting rooms. I betcha more doctors would take Medicare and Medicaid if there was some competition.

Aside from that, many doctors don’t accept medicaid, because it’s the help offered to the indigent and poor, and no-one wants to have a practice soiled by the dregs. Not even hospitals want to treat those people; thence they engage in dumping. It’s hard to get the smell out.

Yeah, cry me a story on how sorry I should feel for doctors…

2. Jim Satterfield - February 12, 2007

Hey, they have huge overhead nowadays courtesy of the private insurance companies, who manufacture enough red tape to put any government agency to shame. And then there’s the cost of their malpractice insurance. Also you need to distinguish between varying specialists and the general practitioners and internal medicine people when it comes to income. Don’t forget the difference between gross and net income. It’s a huge difference for lots of doctors.

3. double-soup tuesday - February 12, 2007

Lets not overplay the significance of lawsuits; for one the insurance is regulated — just enough to make money hand over fist, not regulated enough to actually be useful to anyone of the common public. In places where caps were placed 30 years ago, it didn’t reduce costs.

Secondly, the Prez, in the SOTU went on about tort reform because it’s something that plays with their constituency. And that’s a lot of unmitigated bullshit. Here’s a reference to look through. Let me know if this screams tort reform and lawyerly abuse, or AMA protectionism. The vested interest is NOT in stopping the flow of money to healthcare. And they don’t police themselves anyway (the AMA).

There’s very little risk (to the general public) in bringing in a bunch of Desis. The doctors though; I think they’d see risk.

Report is here.

4. Jim Satterfield - February 12, 2007

I’m not talking lawsuits, I’m just talking about the cost of the insurance. I’m definitely not one of those who blames the cost of the insurance purely on lawsuits. Also, remember that the AMA doesn’t represent all doctors by a long shot.

5. double-soup tuesday - February 13, 2007

Another view of Broder’s story.

6. Jim Satterfield - February 14, 2007

Thanks for the link.


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