Patterico's Pontifications

10/27/2009

Senate Doctors Discuss ObamaCare

Filed under: Government,Health Care,Obama — DRJ @ 9:11 pm



[Guest post by DRJ]

The Senate has 2 members who are also doctors — Oklahoma’s Tom Corburn and Wyoming’s John Barrasso — and they host a twice-a-week discussion entitled “Senate Doctors.” Today’s topic is the pending health care legislation:

Barrasso: “Right now, we’re at a point where Harry Reid has announced yesterday kind of a new plan for the health care bill in the Senate, talked about this so-called public option, government-run insurance and now given an opportunity, Tom, for States to opt out of it.”

Coburn: “Well, States are never going to opt out of it because they will be contributing to it and they would be foolish not to take money back from it. We already have an opt-out program. It’s called Medicaid and none of the States have done it. So this is an identical system to Medicaid which is bankrupting the States and will bankrupt us.”

Senator Coburn says the CBO is scoring the bill now and he wonders why the CBO has the bill’s text but Senators and the public don’t. He also wonders whether it’s Constitutional to require that people buy health care insurance. And if you don’t have time for the whole thing, skip forward to the last 2 minutes where the Senators discuss why ObamaCare will hurt the best doctors most of all.

By the way, Coburn also said we’re about to have government health care.

— DRJ

16 Responses to “Senate Doctors Discuss ObamaCare”

  1. Good question. Is not the power to mandate health insurance reserved for the states, since it is not enumerated in the Constitution?

    Icy Texan (f3a492)

  2. Are you asking what the law is or what they will say the law is? I’m not a Constitutional scholar so I’m not sure about the former. As for the latter, I hope I’m wrong but my guess is courts will view this with the same permissive PC attitude they took in the Chrysler bankruptcy case. And Kelo. And Grutter.

    DRJ (dff2ca)

  3. Of course they will. Anyway, it all falls under the umbrella of “provide for . . . the general welfare”, right?

    Icy Texan (f3a492)

  4. Only two Senators out of 100 are Doctors. And they are voting on a bill written by lawyers to force change on the medical profession.

    tyree (bf0ee2)

  5. The provision to punish the doctors who treat the most difficult cases is an old tactic. When the RBRVS was passed in 1986, the fee schedule for Medicare was set to reduce payment for difficult care, especially surgery and, allegedly, to increase payment for primary care. The second part never happened but provided the pretext for the first. For example, long vascular cases like femoral-tibial bypass, which might save a patient’s foot, were cut by more than 50%. The payment has been cut further and vascular surgery is a dying specialty.

    The intent is to cut the complex, and expensive, care. About two years after RBRVS was passed, I was at a national vascular meeting. At that time, the Ochsner Clinic in New Orleans had the best results with an extremely difficult condition called aortic arch aneurysm. People from all over the country used to send this rare condition to them to correct as they had far better results than anyone else. At the meeting, the chief of vascular surgery spoke and said they were going to have to decline such cases in the future. Each case cost them $250,000 in losses and they could no longer afford it. Of course, not all cases were Medicare but the insurance companies had quickly adopted the Medicare system of calculating payment.

    This will continue and having doctors on salary, as at Ochsner, will not be enough. Eventually, they will try to get to the barefoot doctors approach of 1970s China. That cut costs all right.

    Mike K (2cf494)

  6. Remember:
    The issue isn’t the issue.
    The issue is control.

    kazooskibum (a4dd38)

  7. I guess then we can kiss goodbye all of the popular TV shows that show state of the art surgeries and such saving lives by performing near-miracles. Why doesn’t the public, who love the shows and assume this sort of medicine will always be there for them, rise up against this nonsense. And I am sick of having the statement…everyone agrees that the status quo is unsustainable and we need change…spouted everywhere by both sides of the argument. No, we do not need to change. This is a meme that was repeated over and over so that it would become a truth. Just put in a food-stamps like fix for the truly poor to use for healthcare and leave the rest of us alone!!!

    bio mom (a1e126)

  8. The system needs reform, but not a gov’t takeover of 1/6 of the economy. As we’ve seen with all of the arguments for this plan, it always comes down to the Federal Government controlling more aspects of the nation’s economic levers – welcome to the Weimer Republic, circa 2009.

    Dmac (5ddc52)

  9. “So this is an identical system to Medicaid which is bankrupting the States and will bankrupt us.”

    That’s simply a lie.
    Each person will have to pay a fee to be enrolled, just like every private insurer. The problem -according to some- is that the economic advantage will crowd out private insurers, paving the way to single payer.

    There are so many ways to solve this mess, and so many models that are better than our own, but you opt for chaos theory.
    It’s the “merikan way.

    bored again (d80b5a)

  10. There are so many ways to solve this mess, and so many models that are better than our own

    Which of course Gored Again fails to describe – just trust the Dems to do the right thing, what can possibly go wrong?

    Dmac (5ddc52)

  11. “Which of course Gored Again fails to describe”
    because I’ve done it so many times: Japan, Sweden, France etc.
    All of it involves real regulation and we know how much you hate that.

    “just trust the Dems to do the right thing.”
    No, never. But I do trust them to be lesser of two stupids.

    bored again (d80b5a)

  12. I see bored again is indeed again calling “lies” when he hits a comment he does not understand.

    SPQR (26be8b)

  13. It is nothing if not consistent, Dmac.

    JD (8ea798)

  14. First and last question…what happens when X million people can’t pay the premium? I know the answer, let’s see if the proponents of the reform can figure out where the missing payments come from. Don’t even have to worry about the actual details of the reform. It is a failed non-starter right out of the gate because the super recession cum depression which has begun cannot accommodate any further drain on capital needed for production. Foreign bond buyers (read Japan and China) are through bailing out the US. That bond buying comes from them holding dollars that came from our buying their produce. Hint: we ain’t buying much of anything but oil which doesn’t come from either of those countries. End of story for borrowing from our major trade partners. Next step is increased buying our own debt…result: dollar falls off the cliff along with US bonds. Healthcare reform goes under the bus even if it gets shoved through in its present zombie form. I do feel sorry for all the med students who’ve already borrowed themselves into hell.

    political agnostic (4a0aff)

  15. because I’ve done it so many times: Japan, Sweden, France etc.

    Of course you have…not. You do understand that replying by tossing out names of countries is not the same thing as actually describing their superior healthcare plans in detail, do you not?

    So please educate us on why each of those countries have better healthcare systems than ours, and include the details explaining why you feel that’s true. Sound good, sweetheart?

    Dmac (5ddc52)

  16. well, what is getting missed in discussing the opt out is that a state can only opt out with permission from the Feds, so how likely is that to happen?

    and i think i have said it here before, but as far as the constitution is concerned… first, the feds don’t have a right to regulated health care as for generalized welfare of the nation. one clueless dem claimed that the feds had general police power over this country. they specifically don’t.

    But the commerce clause is often stretched to unrecognizable extremes to support healthcare. there is literally a case where a farmer was punished for growing too much of a crop. he said, “i am not going to sell it, i am going to eat it myself, and therefore my conduct is none of congress’ business.” the supreme court remarkably said that since raising the crops would make him less likely to buy other people’s crops, that he affects interstate commerce and so the feds can come in. under that rubric its hard to imagine any limits to federal power. and indeed recently they tried a medical marijuana version of the same argument with the supreme court and the supreme court said “nope, federal rules.”

    But if that was the case, then i could easily construct an argument about abortion that would allow the federal government to ban it. For instance, if you abort your fetus, then you don’t have a baby. so then you don’t buy baby clothes, diapers, and all that other stuff you buy when you have a baby. therefore abortion affects interstate commerce, case closed right?

    of course the supreme court would never entertain such a thing, but not because the commerce clause argument is invalid, but because they feel that there is a positive right to control your health that includes a right to an abortion.

    But if you have a right to control your health, including a right to an abortion, then isn’t health care reform unconstitutional. how can you have the right to kill your baby, but not to choose your doctor?

    i think what it comes down to is this. they plan to regulate you simply for the act of breathing. its not just the fact that every american is subject to the fed’s rules on this, but the fact that you are literally doing nothing at all to trigger their jurisdiction. normally you have to at least pretend you are engaged in or affecting interstate commerce, but not in this case. if you merely exist you are regulated. and i think the courts will be annoyed that there isn’t even a fig leaf of federalism there.

    A.W. (b1db52)


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