America
Posted by
RMC
on Tuesday, September 15, 2009
A precocious youngster from some lefty organization interviews the clear minded citizens at the "Tea Party" protests in Washington, DC this weekend and elicits some amusing responses.
Unfortunately, these protestors in their revolutionary rage have lost sight of our nation's guiding mantra that this is America: love it or leave it.
15 comments:
Can old people stop taking my tax dollars for "their" social security after they supported the Reagan tax cuts that helped throw this country into perpetual crazy deficits? And can those same old crazy people stop marching demanding that the working class not get healthcare? Jesus.
This is very sad to me because there is an element of legitimate grievance in some of what these people are saying, but it is so misdirected. I think that many of these folks are uneasy with the changes they see in their communities (especially as they get older). The coming demographic shift in this country-- while unavoidable however much they might wish that not to be so-- leads to a lot of anxiety, manifested often as dissatisfaction with Obama, saying he's a nazi kenyan muslim, this absurd Wilson flap, etc.
Banksters damn near broke this country and they're fixing to do it again… raise your hand if you think Obama's proposals for financial industry regulation will lead to any real change of behavior on Wall Street. The political process has been captured by lobbyists-- Dick Durbin said as much on the floor of the Senate earlier this year. The one woman said it-- she's angry about the bailouts. But she's angry at the wrong people! These folks are rightly upset about Wall Street's raiding of the public coffers but deeply confused and scared and misled by entertainers (Rushbo, Beck) with their own agendas. They are arguing against their own self interest and they don't even realize it: insurance reform would HELP them.
I absolutely agree that the political process has been captured by lobbyists - Obama won't even come out and say we need tort reform as a part of healthcare reform
To pick on Brah for a moment, this is exactly what I am talking about.
Here is the text from Obmama's speech JUST A FEW DAYS AGO:
"Now, finally, many in this chamber -- particularly on the Republican side of the aisle -- have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. (Applause.) Now -- there you go. There you go. Now, I don't believe malpractice reform is a silver bullet, but I've talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. (Applause.) So I'm proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine."
I don't know where you are getting this received wisdom that Obama is not talking about tort reform-- unless of course you mean that talking about it on national television and in front of both houses of Congress is "not talking about it". In truth, Obama has been open to tort reform from the beginning of this, as something to be offered to those allegedly bargaining in good faith.
WOHJR, i think this is a far cry from coming out and saying we need tort reform. Obama says "defensive medicine MAY be contributing to unnecessary costs. i'm proposing we move forward on a RANGE of ideas..." smooth talking and dancing around issues does not make one a good politician...
Continuing: the larger issue, as Obama alludes to, is that there are significant questions as to the contribution of malpractice suits to high medical costs. Consider:
* Legal costs for malpractice suits average $27,000 per claim, settlements and judgements are $4.4 billion and insurance is $700 million. This gives a total cost associated with malpractice as 6.5 billion dollars-- less than ONE HALF OF ONE PERCENT (~.046%) of total healthcare costs.
* Average payouts in the US for malpractice claims is 14% lower the Canadian average and 26% lower than the UK average.
* More malpractice claims are filed on average in the US than in Canada, the UK or Australia-- but only 1/3 of those cases end in the plaintiff receiving any money at all. In UK, the rate of recovery (either through judgement or settlement) is over double.
* Claim payments in the US have been growing in line with inflation (5% per year), as compared to those three countries, where claim payments are growing at 10-28% per year.
That last point is key, because one wonders if the above is true, why is malpractice insurance still extremely expensive?
This could offer a clue:
"The report, written by former Missouri Insurance Commissioner Jay Angoff, contends that the amount of premiums collected by 15 major medical malpractice insurers has more than doubled over the past five years. At the same time, the report found that the companies' claim payouts have remained essentially flat [...]
The report said malpractice insurers as a group raised their net premiums between 2000 and 2004 by 120.2 percent, to about $4.2 billion, even though their net claim payments rose by only 5.7 percent, to about $1.4 billion.
As a result, the amount of claim payments made as a percentage of premiums dropped from 69.9 percent in 2000 to 33.6 percent in 2004."
Blaming slimy trial lawyers is the oldest red herring in the book.
So feel free to keep bellowing "tort reform" at the top of your lungs, but if you are blaming high costs on malpractice suits, realize you are being used to obscure the true sources of high cost in our health system.
I don't understand, Brah-- if that isn't coming out for tort reform, what exactly would be?
BESIDES, its in that abomination of a Baucus Bill... you've already got what you want!! This is classic misdirection of legitimate grievance, see my post above.
Hey, wait a second, RMC - I wasn't at this protest! But I wish were. It looked like a pretty good party. Anyone know how many people showed up? I'm hearing estimates of anywhere from 20,000 to 2,000,000 - depending on your political views.
Anyway, appreciate the shout-out in the label. Look at the comments you generated! First we have Anonymous demonstrating some historical ignorance. Contrary to what most (liberals) think, the Reagan tax cuts increased federal receipts by over 50% from 1981 to 1988 (from $599bn to $909bn). The reasons we had deficits is because increases in spending outstripped the rising tax receipts.
And then, WOHJR comes out of the woods to express his characteristic condescension towards those with whom he disagrees. This had to be my favorite line: "They are arguing against their own self interest and they don't even realize it: insurance reform would HELP them." Beautiful.
Anyway, it's been fun following this little political thunderdome between WOHJR and The Brah. I'll be checking in here later to see if this gets any better. Come on Brah, hit him back! 5-4-3-2-1-Chug!
Address the tone, not the substance. Beautiful.
BTW- Where's that Kennedy takedown? Its after labor day, after all...
The only thing that impresses me about this chain of comments is that nobody has made a tea bagging joke yet.
As a dude who is in the medical field (kinda) - I’m a little bit torn on the healthcare issue.
Reform is absolutely needed. I agree with the WOHJR's that providing care to all people is very important. And I agree with the Brah's that reform that attempts to achieves universal coverage without a focus on cost and systemic reforms is at best shortsighted, and at worst, disastrous.
One overlooked but extremely important source of cost is the burden of the regulatory process. The cost of getting a drug to market is extremely high. As a result, companies have to resort to the model of the music industry – relying on the success of huge blockbusters to cover the cost of failures that greatly outnumber the successes. This leads to very high cost of drugs – whereas the margins of an individual drug often seem exorbitant, they are necessary when you consider the cost of drugs that are clinical or commercial failures.
The US system alone bears the burden of these costs. Because our reimbursement is high, companies rely in the US patient in order to afford innovation. Other countries can piggyback on our innovation and pay much less for the drugs since it makes economic sense for drug companies to sell their drugs for much less overseas (I work at a device company, and our product sells for 40% of its US price in Europe) since they are still making positive gross margins. This paradigm is why universal healthcare works in other countries, but not here.
Easing up on regulatory requirements is the only way I see to reduce costs without sacrificing innovation. Of course, this will have an adverse effect on patient safety. Unfortunately, there is no such thing as a free lunch…
Since this is out of character for a typical Bbag comment – I’ll conclude by saying cock cock titties cock.
While WOHJR makes a good point about the relatively low dollar figures of actual settlements, he glosses over a few key points:
- the average cost of mounting a successful legal defense in a malpractice suit is $89,000. There is a real cost to each suit whether or not a claim is paid.
- the real cost savings associated with tort reform are from the discontinuance of defensive doctoring. It is estimated (Kessler and McClellan) that unnecessary tests performed by doctors to cover themselves from liability amount to between $100 and $175 billion per year.
- these cost savings represent approx 10-15x the combined profit of the 10 largest health insurers in 2007.
I agree this isn't a silver bullet but seems like a relatively easy way to help cut back on healthcare costs. While WOHJR has laid out some unsourced facts to refute an opinion of mine above, he has yet to put forward a substantial thought on healthcare reform other than that it is needed.
3....2....1....drink!
Thanks for your substantive response, Brah.
1) Here is my source for the data from the above post-- it is from Health Affairs, a leading, peer reviewed healthcare policy journal.
http://content.healthaffairs.org/cgi/content/abstract/24/4/9031
2) Without a cite, I'm going to have to assume you are referring to this 1996 study by those two:
Daniel Kessler and Mark McClellan, "Do Doctors Practice Defensive Medicine?" Quarterly Journal of Economics, May 1996: 353-390.
Here is what the CBO (under George Bush appointee and McCain campaign advisor Doug Holtz-Eakin) said about this subject in 2004:
"When CBO applied the methods used in the [Kessler McClellan] study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts."
Dartmouth Medical School also has recently published some statistics on this, arriving at much the same conclusion, using Texas as an example as they set malpractice caps at $250k in 2003. Do you have any other sources to back up this assertion?
3) So what should we do? These two studies suggest, at least, the malpractice caps will not be the source of major, or even substantial, savings. The more general problem in our current system is incentives. As in the Texas example (this was discussed along with the Dartmouth findings in a New Yorker article a few months back) health care providers are compensated based on the number of visits and the procedures done. As a result, health care providers’ revenues and profits increase when they deliver more services and the cost of health care goes up. The ex-head of the AMA speculated there could be up to $750 billion (30%!) per year savings with no harm to patient outcomes. This is a lot bigger than .046%. We need to realign incentives in this country so doctors are not compensated by how many tests they order. Remarkably, we already have something like this in the US-- the VA. Undoubtedly there are problems with the VA, but by in large it is extremely popular with veterans, precisely because these perverse incentives are removed-- VA docs have no reason to order superfluous tests. There would be a really easy way to mimic this in the public at large, but it has been deemed "too progressive" to be proposed seriously.
Drawing things full circle here, I'll refer to the woman in the white shirt in the video at the top of the post. She says she likes her Medicare and maybe it should be expanded to more people. I agree! Why not give the opportunity to buy in to Medicare to all? She's unwittingly proposed something more liberal than any of the current proposals in Washington... its called SINGLE PAYER!!
Thanks for your substantive comment, BBag.
I'm a little unclear on your argument though. While your point that European countries may in some sense be "freeloading" off of American drug company innovation may have some merit, surely you cannot be suggesting that if the US were to have health care for all, device and drug manufacturers will simply fold up shop and stop pursuing cutting edge treatments and drugs? If thats what you are asserting, you need to provide some examples of when this has occurred because I don't find this claim persuasive.
Moreover, I'm afraid that your general reasoning is not going to resonate with me. In moral terms- writ large- I think the greater social good is served by providing affordable access to health care to our fellow citizens rather than protecting the current level of profitability of medical device companies (no offense intended to your or your bosses of course).
Guys, behind all of the rhetoric, I think what WOHJR is really saying is, "I'M IN LAW SCHOOL, bitch".
(Get the "I'm in Miami, bitch (trick, for you easily offended)" reference?)
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