Patterico's Pontifications

6/1/2009

Ted Kennedy and the Government Bendover of Healthcare

Filed under: General — Karl @ 10:38 am



[Posted by Karl]

Sen. Ted Kennedy may unveil his healthcare takeover bill as early as today:

The plan in the summary document, provided by two Democrats who do not work for Kennedy, closely resembles extensive changes enacted in the senator’s home state three years ago.

In many respects it adopts the most liberal approaches to health reform being discussed in Washington. Kennedy, for example, embraces a proposal to create a government-sponsored insurance program to compete directly with existing private insurance plans, according to one senior adviser who was not authorized to talk to reporters.

The Massachusetts version of healthcare reform has been an abject failure, as judged by everyone from Reason to the Boston Globe. That would explain the New York Times report that a split had developed between Kennedy and Sen. Max Baucus (D-MT), chairman of the Finance Committee, who is preparing his own bill. Baucus and Kennedy later issued a joint statement Saturday, saying they intend to cooperate so their committees pass similar bills. Kennedy’s bill serves the function of making whatever bill Baucus produces — which will likely be similar to Kennedy’s — seem more moderate by comparison.

Ultimately, as the Washington Post notes, the Democrats’ proposed government takeover of healthcare is being sold as cost-containment, but the Democrats’ proposals will run into the same basic problems as always:

Two cost-saving measures hold the most promise. First, what’s known as comparative effectiveness research, which tracks what works and what doesn’t, would also require outside boards directing doctors and hospitals about what procedures they could and couldn’t use. Policymakers have tended to dance around the second part of the equation. Second, eliminating the tax break for employer-provided health care could generate a good deal of savings and help bring down health-care inflation. But, again, there’s a political challenge; President Obama would have to admit that Sen. John McCain, his GOP opponent in the presidential campaign, was right on this idea.

Here is the bottom line: Most health-care inflation is the result of new technologies. Bending the curve enough to help balance the budget means walking away from some of the new technologies and devices that people want when they are sick. It also means improving consumer cost-consciousness through insurance reform and higher deductibles and co-payments. For most of us, that means paying more, not less. Even then, it is unlikely to be enough to get costs under control.

Asking Americans to pay more for less healthcare is a loser, and the Congressional Budget Office continues to be a thorn in the side of Congressional Democrats trying to pay for their program with faerie dust. As for comparative effectiveness research, Americans will get to hear about how it is already killing cancer patients in Britain. They will also hear about how it would tend to require real colonoscopies instead of virtual ones. Some politican or talk show host will figure out there’s a useful metaphor in that example.

–Karl

44 Responses to “Ted Kennedy and the Government Bendover of Healthcare”

  1. What in the world makes anyone think that the freakin’ federal government is going to be able to contain costs or improve efficiency? That has to be one of the single greatest fantasies brought up when discussing this topic.

    JD (ca9da7)

  2. Massachussetts

    That’s “Massachusetts”, pronounced Mass-a-TOO-setts by our Dear Leader.

    [Corrected. Thanks. -K]

    Dave (in MA) (037445)

  3. Federal taxes on health benefits would probably carry over into state taxes on health care in states (like California) that mostly follow federal rules. Since the states pay nothing extra in benefits, this would be a windfall for the states. Possibly without even having to vote for a tax increase.

    Kevin Murphy (805c5b)

  4. “and the Congressional Budget Office continues to be a thorn in the side of Congressional Democrats trying to pay for their program with faerie dust.”

    The “bond vigilantes” are a much bigger thorn in the side of the Dems. The issue of having to monetize debt in order to backstop the cost of this healthcare plan is, by itself, enough to derail it.

    I’ve been saying for quite a while that the Dems will get universal healthcare right around the same time the GOP gets private individual investment in Social Security.

    Brad S (9f6740)

  5. Federal taxes on health benefits would be another new tax on 95% of Americans right?

    william (fe3a60)

  6. I think health care will be the big issue in Obama’s Presidency, and that’s saying a lot given all he’s done so far, so I’m grateful for your posts on this topic.

    DRJ (180b67)

  7. Getting rid of health care inflation is Unicorns and Pixie Dust.

    1. Demographics support increasing needs.
    2. Population expects nothing but the best since they don’t really pay for it.
    3. MDs over order diagnostics and procedures to avoid lawsuits and make money
    4. Creating an MD takes 15 years — longer than drilling for oil — so even if you started today creating MDs
    5. Dropping profitability for MDs is dissuading many from entering medicine

    All folks who think they can get rid of inflation in the is business are either LIARS or STUPID.

    HeavenSent (1e97ff)

  8. FDR started with a government unburdened by debt. That critical detail is something the One missed. All of the past bills for various bits and pieces of the welfare state are coming due over the next decade. Including the extremely generous pension plans of various government workers.

    Wasn’t it Thatcher who said “The problem with Socialism is you eventually run out of other peoples money.”?

    LarryD (feb78b)

  9. No sure how taxing benefits is going to increase the amount of MDs or decrease the need for services.

    But I am waiting for the Messiah to tell me.

    HeavenSent (1e97ff)

  10. If you smoke will the government treat your lung ailments? They are starting not to in England. How about Type II diabetes if you overeat. What about if they think you drink too much, or engage in risky sports? What about rehab?

    Can’t waste responsible taxpayer’s money on idiots who won’t take care of themselves, eh?

    Kevin Murphy (805c5b)

  11. From your Boston link

    A bill before Congress, the United States National Health Insurance Act, would provide more comprehensive coverage for all. The bill includes doctor, hospital, long-term, mental health, dental, and vision care, prescription drugs, and medical supplies, with no premiums, copayments, or deductibles.

    People would be free to choose doctors and hospitals, and insurance would not be tied to a job. Costs would be controlled because health planning in a national health program can reestablish needed balance between primary/preventive care and high-tech tertiary care. A modest, progressive tax would replace what people currently pay out of pocket. This program would pay for itself by eliminating the wasteful administrative costs and profits of private insurance companies, and save $8 billion to $10 billion in Massachusetts alone.

    We must let Congress know we want improved access to affordable healthcare for all, not more expensive private health insurance we can’t afford to use when we are sick. Massachusetts healthcare reform fails on all five Institute of Medicine criteria. Congress should not make it a model for the nation.

    I’m all for it. Are you?

    bored again christian (e65df2)

  12. Let’s see which eagle-eye Patterico reader can find the next mention of Kennedy’s “universally acknowledged expertise on issues of health care” or “career-long interest in providing health care to all Americans” or some other slavering accolade in the mainstream media.

    JVW (fdc303)

  13. bac – Costs would be controlled because health planning in a national health program can reestablish needed balance between primary/preventive care and high-tech tertiary care.

    Planning? Like our current budgets?

    And – This program would pay for itself by eliminating the wasteful administrative costs and profits of private insurance companies

    Yes, of course. Never any waste in government, right? Of course, the idea that private insurance would ‘waste’ money that comes directly out of profit is laughable.

    Will it make everyone tall, beautiful and rich, too?

    Apogee (e2dc9b)

  14. So in essence, Kennedy is providing the “poison pill” of a failed government-run health care insurance program to contrast to one that hasn’t yet failed.

    I’m all for it. Are you?

    Obama said his “stimulus” plan would stabilize unemployment rates–they have gone up since the stimulus was passed. He’s said that he’s “created or saved” 150,000 jobs during a period when 1.3 million have been lost.

    Obama, the Boston Globe, and you, are making up numbers out of thin air as a means of selling this program. Show us the methodology by which these numbers were determined, and then we can actually have an honest discussion as to whether or not it will be finanically viable. Until then, you’re just spouting propoganda.

    Another Chris (2d8013)

  15. This program would pay for itself by eliminating the wasteful administrative costs and profits of private insurance companies, and save $8 billion to $10 billion in Massachusetts alone.

    …and replace them with wasteful government costs totalling well over $20 billion.

    BAC, what do you think will happen to the employees of the insurance companies? Do you think they’ll still have jobs?

    And what do you think of the government destroying the profit incentive?

    And what about the stockholders in those insurance companies, whose invests (a) no longer pay dividends and (b) are worthless? Some of those stockholders are private pensions or mutual funds held by the 401k plans of regular Joes.

    Still all for it?

    Steverino (69d941)

  16. Two items are important. The alleged savings by administrative efficiency may actually be real but it will be frittered away and will not pay for the additional coverage that will be mandated. A bare bones coverage with the option to add coverage through private plans, similar to the French system, would probably be a big improvement. I can see no way that this will come from Democrats.

    Two, they are looking for ways to pay for this and carbon credits s not going to do it. Foolish Republicans and libertarians have been talking for years about a flat sales tax and elimination of the income tax. Hugh Hewitt has a book out that explains why this is a fantasy. The sales tax would have to be 37% or some such number to replace income tax.

    I will tell you where this will lead, however, unless people shut up and see where the Democrats will go with this. I think there is a 50% chance that Obama will come up with a VAT tax proposal to pay for health care by the end of the year. This is a terrible idea but it is the only way they can find the money. Among other things, VAT is a regressive tax and very, very easy to manipulate for political purposes. For that reason alone, I expect to see it soon.

    Mike K (2cf494)

  17. The only way this wouldn’t suck would be if all members of the House and Senate had to use the exact same plan.

    Bob O (cd2d7e)

  18. Why not admit it? You’re opposed to universal health whether it works or not.

    It works, in other countries. Germany, France. In England before Thatcher began to hack away at it. The Netherlands. Canada.
    I remember the “scandal” when the Canadian family had to drive thousands of miles to give birth in the US because there was no more room in a local hospital. Except that they were flown there and charged nothing. There’s a baby boom in their area- no room at the inn.
    No scandal at all. But south of the border is sometimes closer How nice that the Canadian government didn’t care.
    Rightists argue by the logic that everyone is as shallow stingy anti-social and venal as they are. It’s just not true.

    bored again christian (e65df2)

  19. But, again, there’s a political challenge; President Obama would have to admit that Sen. John McCain, his GOP opponent in the presidential campaign, was right on this idea.

    That’s no challenge. Obama would just do what he does every other time he steals an idea from Bush of McCain that he derided during the campaign–announce that he’s making a clean break from the politics of the past and then wait for the media to explain how wonderful or at least justified his new policy is.

    tim maguire (4a98f0)

  20. bored again, your ignorance of the problems with Britain’s NHS and Canada’s systems is quite hilarious. And France’s system is working so well as you put it that the French govt is proposing completely revising it…

    You give up any attempt at substantive defenses of those systems without even trying and then jump straight to namecalling.

    SPQR (72771e)

  21. Somewhat OT, but here’s one reason why you won’t see critical coverage of KennedyCare

    How the Obama administration can save newspapers
    It needs to get over antitrust concerns and allow papers to find more ways to charge for online content.
    Tim Rutten
    May 30, 2009
    Executives from many of America’s leading newspaper companies and the head of the Associated Press met quietly in Chicago on Thursday to discuss ways to increase revenues from their online operations — presumably by charging visitors to their websites — as well as how to recapture some share of their catastrophically declining classified ad business. . .

    Brother Bradley J. Fikes, C.O.R., (4c7356)

  22. Hasn’t bac .20 been banned under multiple nommes de idiocy before? If the Canadian system is so great, bac, feel free to move there and avail yourself of it.

    You were right about one thing. I do not care if governement run healthcare works. It is not the role of the government, at least not in the sense of the Constitution. And, it is abject idiocy to think the federal government can achieve cost savings and efficiencies greater than the private sector. There is simply no evidence to support that, and reams of evidence to the contrary.

    JD (584916)

  23. JD, whenever someone tells me about how great Canadian health care is, all I do is think of when my friend’s wife tore out here knee and it took over a year and a half before she got it repaired surgically. Roughly 9 months for an MRI and another 9 waiting in line for the surgery.

    SPQR (72771e)

  24. Every few months we get another newbie commenting here and asserting that the European/Canadian/Cuban model for health care is vastly superior to ours and that it is 100% efficient and universally loved by the its citizens. Rather than rehashing that argument, we should just direct folks like bored again christian to the previous discussions where they can easily find refutation to their arguments.

    JVW (fdc303)

  25. Only a fool would make any semblance of claims regarding the “superiority” of healthcare that BAC tiresomely does – I’ve been visiting Canada for decades at this point, and NO ONE up there ever claims that their system is superior anymore. In fact, they all hate it with a passion, and cannot wait until the system’s dumped in favor of something along the lines of the French model.

    If I had been diagnosed in Canada, I’d be dead a long time by now. Tell me what other system would have allowed this to happen: I was looked at by GP, who immediately sent me to see a surgeon for a consult the same day, who then sent me to the local hospital for a CT – Scan the next day. I then underwent surgery the next week for a biopsy, which confirmed lymphoma, stage 4. I immediately began chemo the week after that confirmation. I would’ve had to wait at least three months for just a CT – Scan in Canada, which would have been laughably way too late to do me any good. This is something that routinely happens to our neighbors up north, which is why if they think anything’s seriously amiss, they hightail it immediately to the lower 48. Someone should ask Liam Neeson how he feels the Canadian heathcare system performed regarding his wife’s untimely and possibly preventable death.

    Dmac (1ddf7e)

  26. Rather than rehashing that argument, we should just direct folks like bored again christian to the previous discussions where they can easily find refutation to their arguments.

    You’re presuming that they even care if their argument is refuted or not. I’m leaning towards the latter.

    Notice how quickly this particular troll, rather than substantiate his or her claims with anything approaching actual evidence, immediately leapt to a variation of that popular leftist trope, the “you want us all to die and hate humanity” meme.

    Such individuals cannot be accepted in good faith. Treat their arguments with the contempt they deserve, and demand they actually prove their assertions. Once they inevitably fail, future blanket dismissal of their positions then becomes a given.

    Another Chris (2d8013)

  27. There are no refutations of my statements on this site.
    You don’t give figures you give gossip.

    http://scienceblogs.com/denialism/2009/05/are_patients_in_universal_heal.php

    http://www.npr.org/templates/story/story.php?storyId=89626309

    I could go on and on with facts and figures but figures don’t matter much do you do they?

    bored again christian (e65df2)

  28. Max Baucus is our senator, and he’s been doing town hall meetings around the state the last couple weeks. The meetings are packed with activists *demanding* single payer or else. The leftist reformers here view him as a big loser who is letting down the cause. No one I know ever even talks about this stuff.

    Isn’t the Massachusetts system also known as MittCare?

    cassandra (5a5d33)

  29. …would also require outside boards directing doctors and hospitals about what procedures they could and couldn’t use.

    And I’m sure they will be impartial professionals, no union members, party hacks, or campaign donors on board at all!

    And BTW, France’s health care system, as of last summer, is billions in the red, as even CBS News admits.France Health Care.

    Patricia (2183bb)

  30. Regarding the different healthcare systems, the best test is how people vote with their feet. How often do Canadians come to the U.S. for medical care? Often. They even often pay out of their own pocket.

    How often do Americans go to Canada for healthcare? Almost never.

    (Exclude tourists who happen to be in the other country and get injured or sick.)

    Which do you think is better?

    Bored Lawyer (44ef84)

  31. bored again christian, you are not going on with facts and figures actually. You’ve never even started. Now that you’ve added two links that you obviously didn’t even bother to read, just grabbed from some talking points sheet that you don’t understand, we can see just how clueless you are.

    Given that the British Medical Journal published a study in 2005 that concluded that Kaiser Permanente gave better care at about the same cost as Britain’s NHS, there is no reason to believe that “universal” health care is superior to what’s available in the US.

    SPQR (72771e)

  32. Why not admit it? You’re opposed to universal health whether it works or not.

    It works, in other countries. Germany, France. In England before Thatcher began to hack away at it. The Netherlands. Canada.

    It’s annoying when people (probably a troll) makes statements that are so ignorant. I was a consultant to the NHS district of the North Riding of Yorkshire in 1995 when the Thatcher reforms were being implemented. Does “bored” even know what those changes were ?

    What happened was that Thatcher introduced a program called “fund holding.” It was a way for GPs to get some control of their patients who were referred to hospital. Typically, until then, a patient who needed surgery went off to hospital and reappeared (or not, although British surgery was very good until recently ) a few months later. The GP had no way of knowing what happened. He was excluded from the entire record system and had no say about how his (or her) own patents were treated.

    What Thatcher introduced is a bit like an American HMO with the GP in more control. The GP was assigned a budget for the most common major hospital procedures experienced by his patients. If, in his panel of 3,000 patients, 20 had total hips in an average year, he was given a budget of the payment for 20 hips (plus all the other procedures and admissions for nonsurgical diagnoses). He then was allowed to negotiate a contract with the hospitals in his general area, not just the district hospital that had always admitted his patents by geographic criteria. He could send his patients to any of the hospitals and any of the consultants within a reasonable distance.

    Suddenly, the GP was someone who mattered. It took them a while to figure this out. The sharper hospital administrators figured out that contacting the GP, getting to know who he was, showing him around the hospital and letting him know in a timely fashion what transpired with his patients, was the way to get those admissions and those cases. The result was that patients were seen more promptly, shorter waits since he could send them to another surgeon or another hospital if the wait was too long at one place.

    Not only that but he was allowed to drive a harder bargain. If he got one hospital to do the 20 hips for 80% of the budget, the other 20% was available for other care, like immunizing kids or making more house calls. The result was a rudimentary market system that reduced the queue and allowed better care. I know of surgeons who even began to have office hours in smaller communities instead of making the patient go to the city for every office visit. It’s wonderful what a market system, even a rudimentary one, can do.

    When Labour came in, they immediately announced the Thatcher reforms were over but, like Obama, they kept on doing what she had introduced without letting anyone know. I went over there from Dartmouth as a consultant to help them figure out how to negotiate and how to deal with the hospitals and the district administrators. It was fun learning about their system and helping them figure out how to negotiate on behalf of their patients. Most of my contact was with the people who administered the GP practices. We ran a mini-course on negotiating. They had never done this before.

    There is a lot about the NHS, the real NHS, that most of the so-called US experts don’t know. The rural GPs are a lot more like US GPs and the clinics that most academics think make up NHS care. Remember that England is still very rural and the rural parts are poor parts.

    Mike K (2cf494)

  33. Hey, Mike, bored has facts and figures, he doan need no reality.

    SPQR (72771e)

  34. Mike K.
    Beautiful work, dispatching that cliche-spewing ignoramus with precise facts.

    Brother Bradley J. Fikes, C.O.R., (a29db1)

  35. Quality aside, healthcare is less pleasant in areas of the country what have high concentrations of dirty socialists. It’s not “the system” so much as it’s just an organic reflection of how nobody likes serving dirty socialists. It doesn’t matter if it’s a mocha latte or an MRI. They whine and mewl and want to “dialog” inappropriately when they should shut up and they’re notoriously litigious and people just don’t like dealing with them.

    happyfeet (71f55e)

  36. Between Mike K and happyfeet, BAC .27 ought to feel embarassed. Sadly, it prolly thinks it proved something here.

    Did you know that Cuba has a better infant mortality rate than the USA, and the US system has been ranked 32nd in the world? Deal.

    JD (6675bb)

  37. Mike I read the first page of the documentation you supplied, but I have to think you didn’t.
    And also what where the administrative costs before and after her introduction of the internal market?
    Reform is one thing “reform” another. You talk like a market ideologue.
    I watched the CBS piece.
    The host says: “critics call that socialized medicine”
    Well, it is. He was an idiot.
    Watch the video and see what you think. Then do some research on Spain, Germany, The Netherlands, Canada etc. And if someone is going to claim people come here from the great white north for medical treatment bring me the stats. You didn’t, I will
    http://content.healthaffairs.org/cgi/reprint/17/1/225.pdf

    http://healthypolicy.typepad.com/blog/2005/11/blame_canada.html

    duvel (8843e6)

  38. The blizzard of boneheadedness continues apace.

    JD (6675bb)

  39. Mike I read the first page of the documentation you supplied, but I have to think you didn’t.
    And also what where the administrative costs before and after her introduction of the internal market?

    Thank you for showing us all what an expert you are. Now, it’s your turn. Explain fund holding and you could even explain the similarities and differences between Spain, Germany and the NHS.

    Go ahead. You are obviously more knowledgeable than I am. Let’s see what you have to say ?

    What were the administrative costs before and after ? I’ll bite. Show us your expertise.

    Mike K (2cf494)

  40. 😉

    JD (6675bb)

  41. Where did all those crickets come from ? Do trolls carry them around to let loose when they are asked a courteous question ?

    Mike K (2cf494)

  42. The crickets are used to cover the sounds of their footsteps as they beat a hasty retreat.

    AD - RtR/OS! (f5973e)

  43. […] doesn’t,” in pushing comparative effectiveness research, despite the fact that it is already killing cancer patients in Britain, to name but one example. (Indeed, no one followed up on his semi-oblique suggestion that America […]

    The Greenroom » Forum Archive » Obamacare Infomercial: What Were They Thinking? (e2f069)


Powered by WordPress.

Page loaded in: 0.3862 secs.