Patterico's Pontifications


Government Healthcare Takeover: State of Play

Filed under: General — Karl @ 5:36 am

[Posted by Karl]

Pres. Obama’s “watershed” photo-op with industry groups on healthcare “reform” yesterday was anything but a watershed.  Keith Hennessey sums it up:

The President is attempting to claim credit for savings that (a) do not yet exist, (b) are not backed up by any specific changes in industry practices or government policies, and (c) are related to him only in that the groups announced they were adopting his quantitative goal.  For all three of these reasons, the President’s claim that these savings will materialize is wildly unrealistic, and it is absurd to attach a per-family savings number to it.

RTWT, if only for the amusing sports analogy Hennessey rolls out.  Moreover, it is not just people on the Right left unimpressed.  The New York Times analysis of the event merely tries to draw a smiley face on the points Hennessey makes, while noting:

None of the proposals are enforceable, and none of the savings are guaranteed. Without such a guarantee, budget rules would normally prevent Congress from using the savings to pay for new initiatives to cover the uninsured. 

Meanwhile, lefty blogger Ezra Klein has figured out that the photo-op had two sides:

[I]t’s not just the administration that benefits from the optics. It’s the medical industry. The fact that the White House is making a big deal of their support means it would be a big deal if they lost it. And so it’s worth asking what, exactly, the health care industry has committed itself to.

And the answer is: Not much. As one senior administration official said to me, “this is a commitment, not a plan.” The industry coalition has gestured towards various areas of potential savings — among them billing reform, health information technology, and linking payment to outcomes. But they’ve not presented a detailed proposal for attaining them. They have not set down enforcement mechanisms. Put simply, they are, at this juncture, helping the White House with its messaging. But that doesn’t mean they will help the White House with its legislation.


What we have, in other words, are promises of future cost containment that exist alongside concrete and continued opposition to the cost containment ideas that are actually on the table.

Indeed, Klein notes that the pharmaceutical industry and the device industry already successfully defeated one of Obama’s healthcare gambits in the original stimulus bill.

What next?  Buried on Page A16, the New York Times reports that the 45 members of the Blue Dog Coalition in the House are protesting the secrecy of the committee chairmen writing the House bill.  Alienating moderate Democrats seems like a dumb way to advance a government takeover of healthcare that is already unaffordable.  The Obama administration has deliberately left its plan vague, on the theory that Clintoncare failed in 1994 after Hillary drafted a secret plan and dumped it on Congress.  It is far from clear that Henry Waxman, George Miller and Charlie Rangel drafting a healthcare takeover in secret will be seen by the public as an improvement.


Update: That $2.2 trillion in savings promised at the photo-op? Try $215 billion

Update x2: The “comparative effectiveness research” Obama already tried to get in the stimulus bill is already killing patients in Britain.


57 Responses to “Government Healthcare Takeover: State of Play”

  1. If Obama’s already lost Ezra, he’s lost the nutroots.

    daleyrocks (5d22c0)

  2. Denialists

    JD (c6b598)

  3. I new talking point that showed up yesterday ..

    Ignore the fact (or any other facts) that Obama supported a “single payer” plan (but said there wasn’t support for it yet) back in 2003 and 2008, rather what is important is the plan he is putting forth now.

    That seems like a tall order .. it’s sort of like saying you should ignore any Japanese ships heading toward Pearl Harbor in early Dec 1941.

    Neo (46a1a2)

  4. It’s all about blocking access to tailored care. You can cut a lot of fat out if you won’t pay for end of life care, won’t pay for sedation, won’t pay for “free range” diagnostic testing (must work work work to make an outside the herd order for MRI, etc).

    SarahW (fdd722)

  5. SarahW writes:

    You can cut a lot of fat out if you won’t pay for end of life care…

    This is the dirty little secret that puts the lie to the claims about preventative care saving money — which we hear from Obama to Gingrich. As long as people die, preventative care only increases the odds that they will die of something more expensive.

    And yet I doubt we’ll be seeing Obama or any other Dem float the idea of curtailing end of life care. They’ll wait until the public is trapped in a government system, and have bureacrats ration that care away.

    Karl (3bf5f8)

  6. I think if I had been forced to use Obama’s healthcare plan, I’d be dead by now. In talking about it with the denizens of our neighbor to the north over the past few years, I’d certainly have died in their system quite easily (hey, cost savings! Yippee!)

    Dmac (1ddf7e)

  7. I live with a doctor who lives by every word that comes out of the Obamessiah’s mouth. I love her very much, but I am still looking forward to the day that she just cannot buy that fifteenth pair of Cole Hahns because one of the Magical Mau Mau’s natural constituency needs the fee he would have paid her, for a case of Colt .45 Malt Liquor and a bag of pork rinds, more than she does.

    nk the [former] Harley Rider (755c01)

  8. Should have put a smiley 😉 there.

    nk (755c01)

  9. Whoa- kind of racist. Malt liquor and chitlins? The homeless suffered greatly under W but still managed to obtain their booze, ciggies and crack.

    Can your better half doctor kindly explain just what is that makes people partake of the kool-aid after listening to his drivel or gazing upon mis messianic image? Why is his stance on gay marriage acceptable to obots but a young beauty contestant’s not?
    I recall being quit frustrated trying to get answers about why women were fascinated with Bill Clinton. One lady insisted oral sex was not sex, but when I queried whether it was ok for her husband to accept BJs from other women, she became ticked and said feck off, of course HER mate better behave.

    aoibhneas (23d596)

  10. Oddly enough, though some might consider the term “Mau Mau” racist. It could be applicable as one of Barack Hussein Obama’s relatives was a member of the Mau Maus, and I do not refer to the street gang ones but the ones that butchered people in Kenya. So if you were ready to consider the biker, or rather the former biker a racist, don’t.

    Zelsdorf Ragshaft III (57cae1)

  11. The Mau Mau were Kenyans (Obama, check), and extreme (Obama, check), and Soviet-style Communists (Obama, check.)

    nk (755c01)

  12. Can your better half doctor kindly explain just what is that makes people partake of the kool-aid after listening to his drivel or gazing upon mis messianic image?

    No, she cannot. She is a wonderfully kind person, raising a daughter she would die for, but she has no objection to some another Obamaphile saying Palin should have aborted Trig. Inside our own house. It’s an enigma.

    It could be my fault. I never beat her. 😉

    nk (755c01)

  13. For the food-impaired reader – “bag of pork rinds” =/= “chitlins” (chitterlings). As for the Colt .45, like Billy Dee said – works every time.

    carlitos (aa025a)

  14. Dmac, #9: well, I’m glad you didn’t have to rely on an Canadian or UK-style system. We may be going there. We may not. I sure looks like the former, but I would be delighted to be wrong.

    The think that irks me no end, to repeat myself, is that the congresscritters who just “know best” will not be using this form of health coverages. That’s just for the proles like us. They will get top-flight coverage, no matter what.

    Now, if every member of the government that voted on this was FORCED to use the system they put into place…well….

    Seriously, as long as the government officials are fully insulated from the consequences of these kinds of proposals, they will continue to use them as cheap political talking points.

    It’s like the old school busing issue, while the politicians carrying on about it had their children in private school.

    Or, to take another example, pontificating on a voucher system being a bad idea while having your own kids at Sidwell Friends.


    Eric Blair (262ccd)

  15. Obviously your fault, nk.

    SPQR (72771e)

  16. When it comes to proposals like this, I employ JD’s Rule of Government – Factor of 10. If the government is willing to give you a cost of a new program, multiply that by 10 to get closer to the actual cost. If the government claims savings, divide that number by 10 to get closer to the actual savings.

    JD (c6b598)

  17. nk, all politics is personal. My mother in law is super Left of center, and would often bring up pretty rude comments about the Right. I never fought with her. She is family.

    One Christmas, my father-in-law started in at a family gathering about how stupid people on the Right were, laughing about it. I just looked at my mother-in-law and said nothing. She turned very red.

    After that, she never—and I mean never—has said another nasty thing about the Right in my presence. In fact, she has asked me what I believe and why.

    I’m not saying that she agrees with me, but she sure saw the warts on her own side. She has told me more than once that she wants to show that “her side” is better, and insults do not do so.

    For example, she was furious about how Sarah Palin was treated by the press and her friends. She could not disagree more with the views of Governor Palin, but again, my mother-in-law has seen how crude and personal things have become.

    By the way, my father-in-law is a good man. He has let politics—and the fact that none of his own circle of friends disagrees with Left commentary—close his mind.

    My wife started out being Left of center. The more she saw how folks in the Right—including her husband—were treated in academia, the more her own views shifted. Heck, my wife listens to Rush Limbaugh daily. Which is probably why my mother-in-law started out with all the insults so long ago.

    Thus: it’s always personal. And it cuts both ways.

    Eric Blair (262ccd)

  18. A Corollary to JD’s Rule of Government is that if the government tells you that they will “create or save”, they are being intentionally deceptive.

    JD (c6b598)

  19. True story.

    About 30 years ago, my father and I, during our vacation, are on the roof, resurfacing it. We hear a voice from the diriveway. It’s my mother. We ask, “Mama, why are you back from work so early?” She says, “I fell on a machine at work. The factory doctor said I have three cracked ribs and he sent me home”. We say, “Go inside and lie down. We’ll come down right away and look after you”. My father and I come down off the roof and we see her sweeping the driveway. I say, “Pop, do something”. He says, “What do you want me to do?” I say, “Beat her”. He says, “When you beat them, they get sulky and don’t work as hard”.

    nk (755c01)

  20. nk, but they are quieter when sulky.

    SPQR (72771e)

  21. Sexist misogynistics racist homophobes. You never disappoint.

    JD (c6b598)

  22. If it was Dana, we could impose the ultimate punishment:
    Confiscation of her Jimmy Choo’s!
    But the whining would probably be unbearable.

    AD - RtR/OS! (3eaf60)

  23. Hiding the Coach and Dooney & Bourke from Better Half would be a crime punishable by … Something horrific.

    JD (c6b598)

  24. Wife beaters.

    The Emperor7 (1b037c)

  25. Disclaimer….
    “No Wife, No Horse, No Moustache”

    AD - RtR/OS! (3eaf60)

  26. No you didn’t….

    The Emperor7 (1b037c)

  27. Conspicuously absent were representatives from the Tort Bar. I wonder how many tens of billions in health care dollars we could save each year by eliminating perpetual, and frequently fraudulent, litigation… think silicosis, asbestosis, breast implants etc.. Wake-up America!

    M. Stanley Kron, M.D. (aaf938)

  28. Karl, did you note this line in that piece about oncology (admittedly the real impact area of rationing)?

    Compared to France, Britain only uses a tenth of the drugs marketed in the last two years.


    Mike K (90939b)

  29. As for yesterday’s meeting, is there a list of who attended and minutes of the meeting available or do I have to FOIA request.

    Neo (46a1a2)

  30. Comment by Mike K — 5/12/2009 @ 1:01 pm

    And now, the government in the U.K. is attempting to cutback on pub hours.
    You can’t get any painkillers from NHS, and you can’t self-medicate at the local pub.
    No wonder most Brits have such a pained expression on their face.

    AD - RtR/OS! (3eaf60)

  31. Do The Patriotic Thing: Get hit by a bus at age 70.

    Techie (9c008e)

  32. think silicosis, asbestosis, breast implants etc.. Wake-up America!

    Comment by M. Stanley Kron, M.D. — 5/12/2009 @ 12:57 pm

    Think 5 to 11 million dollars for CP. Think a $60,000.00 tail for a Family Practice doctor who wants to take two years off to raise her kid.

    nk (755c01)

  33. I just realized I have been doing what gun buyers have been doing since obama took office. They went on a buying binge because they feel threatened (with good reason). I have been getting physicals and other doctor appointments because I know when obama turns his sights on medical care, I will be unable to be diagnosed or treated.
    And I know that, because I am a 60 year old woman with health problems, he will make sure the medical care is not there for me, I will have no value in his brave new world.

    J (c59f75)

  34. Do The Patriotic Thing: Get hit by a bus at age 70.

    We can always move the Carousel age back a few years if we can’t meet the budgets.

    Steverino (69d941)

  35. Left unanswered is always how, or rather, who will pay for this. Tax revenues were revised downward by almost 90 Billion dollars today, wiping out that huge 17 billion in savings claimed last week, and adding almost 80 billion more to the deficit. Barcky’s lie about offsetting new spending for net negative was the most brazen of his lies.

    JD (c4dd89)

  36. Signs from the last Treasury auction indicate that the credit markets are going to start marking US debt toward banana republic status.

    SPQR (72771e)

  37. Comment by Techie — 5/12/2009 @ 2:33 pm

    Make it 61, so there won’t be any impact on SS.
    Do Your Part,
    Die for Uncle Sam!

    AD - RtR/OS! (3eaf60)

  38. “Update: That $2.2 trillion in savings promised at the photo-op? Try $215 billion.”

    Karl – Those pikers should have been able to balloon up that $215 billion into at least $4 trillion of savings over the next ten years without batting an eyelash. He’s losing his touch! On January 20 he would have clamed that the savings alone would have paid for the program and wiped out his projected deficits.

    The job is obviously getting to him.

    Where is the HOPE?

    daleyrocks (5d22c0)

  39. Please forgive me, but I must post this.

    Late last October, 2008, I found out I had Prostate Cancer-level 6 on the Gleason scale.
    I have been battling this Cancer ever since. I also am going to see a nuerologist in the near future for some severe headaches I have. My heart is still ticking though, since my hospital visit at the beginning of May, 2008.

    One thing let me get pefectly out there for everyone: I WILL NOT LAY DOWN-ROLL OVER-AND DIE.

    Now to some items:

    Perez Hilton (Mario Lavendaria the other mario), and his croonies are trying to stir up problems with Patterico (Patrick Frey) and myself. Well, they didn’t do their homework thoroughly. Patrick Frey and me HAVE NOT been enemies for quite awhile. Here is a blog that Patrick put up. He is the FIRST law enforcement person that has ever given me credit publicly.

    My comment back to him is number 10.
    Mr. Patterico also gave me (Mario Nitrini) his telephone number through a very good friend of mine. I gotta tell everyone this, it took A LOT of guts and integrity for Patrick to say what he said about me in the comment section of the blog above.
    Patrick, those messages that you requested from me are VERY telling and VERY Toxic. And please understand, they ARE NOT MY WORDS, they are someone else’s. I am very uneasy about them.

    Now Mr. Patterico blogged this:

    Paul Barresi is talking about me. Barresi IS NOT telling it like it is (DAH). Barresi also says that Anthony Pellicano, and I quote Pellicano:

    “he deserved a good beating.” HA, HA, together, Pellicano and Barresi couldn’t beat me up on my worst day.

    OJ Simpson Case investigator Bill Pavelic has been trashing Patrick Frey’s boss Steve Cooley in a so-called tell all OJ Simpson Book “Guilty of Incompetence.” Patrick, I will Legally Impeach Bill Pavelic if Steve Cooley wants me to.

    In the Robert Blake Criminal Trial, Patrick, your side (The Plaintiff’s) never had a chance of winning, (MOLES)

    In the Biggie Smalls Federal Lawsuit Case, Patrick, your side doesn’t have a chance of winning, (MOLES).

    Quite an allegation that John Mctiernan makes about Karl Rove and certain aspect’s of The Anthony Pellicano Federal Indictment Case. Is Mr. Mctiernan the Looniest-of-toon’s in the 21st century grabbing at invisible needles in a haystack? or is there something to his allegation?

    Now Patrick, to lighten thing’s up and to the last and maybe the most important item—LOL

    If my friend Brian “Wukong” Murray is the King of the minion’s
    and my friend Sweet Pea (Vicki) is the Queen of the minion’s.
    Could that possibly mean that my friend
    Luke Y. Thompson (LYT) is the


    The OJ Simpson Case
    The Anthony Pellicano Federal Indictment Case
    The Biggie Smalls Federal Lawsuit Case
    The Michael Jackson Case and Saga
    The Robert Blake Case

    Mario George Nitrini 111 (ffed55)

  40. Who let Mario the Nutbag out of the Asylum?

    daleyrocks (5d22c0)

  41. Don’t look at me.

    SPQR (72771e)

  42. One Troll leaves, another one enters.

    Dmac (1ddf7e)

  43. He’s been here before. He won’t be here long.

    daleyrocks (5d22c0)

  44. No, really, don’t look at me.

    SPQR (72771e)

  45. “this is a fill-in-the-blank, not a plan.”

    I’m sensing a pattern forming

    Neo (46a1a2)

  46. Comment by Mario George Nitrini 111 — 5/12/2009 @ 3:57 pm

    I’m always a bit confused when this commenter appears – I’m not sure what to say, or do, or what it is he wants. I hope someone does. But wow, what a nifty drama-filled handle. It makes Esq. seem rather pedestrian.

    Dana (4a6e8c)

  47. Is that krazy person related to MKDP and David Petranos, Esq? I miss them. A LOT. One can never tire of being regaled with stories of frogmen, disability horses, roast beef cutters, snipers, and frivolous litigation.

    JD (b9ca6b)

  48. JD, don’t you even start with them!

    Dana (4a6e8c)

  49. * ducks a flying Jimmy Choo, flung by a hottie photographer 😉

    David Petranos Esq. And MKDP – Pay no nevermind to people like Dana. They just have not had the pleasure of sufficient exposure to your brilliance in order to appreciate it. I, on the other hand, am a devoted fan. Please come back. I beg you.

    JD (b9ca6b)

  50. Mario 111 – Try They like to help people over at that site. I thought you didn’t like Patterico.

    daleyrocks (5d22c0)

  51. The AMA has zero credibility with most docs. They will get in bed with Obama instantly in hopes of having a role to play, possible as gauleiter in the new rationing scheme. Our only hope is a private option which will allow a parallel system to contrast with the government universal Medicaid program.

    My experience with government medicine goes back to 1965 when Medicare and Medicaid began. Johnson took the advice of Bevan who, when the NHS began, “filled their mouths with gold” to get specialists on board. That meant generous terms early on. Of course, as the years went by, those pay scales stayed the same. In the early years of Medicare, reimbursement rates were good.

    Medicaid, the program for the poor, was never as generous. In fact, right from the start, Medicaid (MediCal in California) paid slowly and poorly so the program was quickly taken over by “mills” that would make money by running large numbers of poor patients through the system, billing for every known test. As this became obvious, Medicaid responded, not by boosting reimbursement to attract more mainstream doctors, but by progressively more and more onerous rules and lengthy delays in payment.

    I even knew doctors who quit residency programs to open Medicaid mills in the late 1960s. The chance to make money was too good and they passed up more training. When I began in practice in 1972, having finished six years of postgraduate training, I signed up for MediCal as a sort of patriotic gesture even though I was in middle class Orange County. MY office was quickly filled with women wanting varicose vein injections. I was the only one doing them for years in OC. Soon I found that MediCal paid about six dollars after about 18 months for the procedure. My office staff pleaded for me to quit the program and I obliged. After that, I saw MediCal patients only on the request of other docs, many of whom also cared for them but never listed themselves as participants. Of course, we also got a lot of them from ER call

    Now, I suspect, there will be less concern about sweetening the pot as the feds will have the only game in town. That is why the private option is so important. They could do a good job with a single payer program but I don’t see why this should be the only thing that Obama does competently.

    Mike K (2cf494)

  52. I would be more comfortable with this idea were Barcky to have some kind of track record of implementing these kinds of massive take-overs, successfully. Given his complete lack of success with Annennberg, after spending hundreds of millions, the idea of his spending millions of millions is not the least bit comforting.

    JD (80dce8)

  53. […] toward the cost of insuring the 47 million Americans without health coverage. Too bad that’s less than the $215 billion previously pledged, and a fraction of the $2.2 trillion Pres. Obama promised. About $100 billion would come through […]

    The Greenroom » Forum Archive » Obamacare at Recess (e2f069)

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