Obama and Yogi
Can the salesman-in-chief overcome public doubts on health reform?
Obama and Yogi
I've been around the block too many times to believe that President Obama and the congressional Democrats will pull off the near-impossible and fix all that ails the health care system.
A screenwriter could easily conjure a Hollywood ending: Obama, by dint of his magic touch, manages to expand coverage to every American while reducing the cost of treatment, all without driving up the deficit, with just enough of a "public option" insurance plan to satisfy the liberals, with just enough lawsuit protection to satisfy the doctors, and in the end he wins grudging applause from the insurance companies and the Republicans and the consumers and the budget hawks and the trial lawyers and the hospitals...
Good luck with all that.
Obama is moving into the toughest phase of the health care fight - that would be the congressional devil-in-the-details sausage-making phase - and it's questionable whether any president could achieve what needs to be done, no matter how potent his skills as a salesman may be. There's a reason why substantive health care reform has remained unachievable since it was first floated nearly 90 years ago (when it was called "compulsory health insurance"). There are too many competing interests; moreover, the most powerful advocates for the status quo have long been successful in equating reform with the bogeyman of the moment, be it socialism or communism.
For reform to be successful, Americans have to be willing to take a calculated leap into the unknown. Opponents of reform have the easy job; all they need to do is sow doubt. Americans may believe in the abstract that the health care system badly needs fixing, but if they can be persuaded that reform might somehow imperil the quality of their own health care, then it's game over and the status quo lobby wins.
President Clinton's first pollster, Stanley Greenberg, discovered all this back in '93. He went into the field to survey Americans, and found tremendous support for health care reform - yet we all know how that battle turned out in '94. And recently Greenberg went back into the field on his own to ask Americans how they felt about Barack Obama's push for health care reform...and guess what:
As Yogi Berra once remarked, it was deja vu all over again.
Greenberg now finds the same broad theoretical support for health care reform as in '93, and, more importantly, he finds the same soft underbelly of support as in '93 - which could again be exploited by those who are deft at sowing doubt.
Greenberg is credible on this issue precisely because he's a Democrat whose ultimate loyalty is to his polling numbers. Writing today in The New Republic, he recalls his reaction as he compared his new stats to his '93 stats: "Oh no. It can't be. Nothing's changed."
He observes: "Then and now, the country proclaimed its readiness for bold reform. In both instances, one-quarter say that the health care system 'has so many problems that we need to completely rebuild it'; half the country sees 'good things' in the current system, but believes 'some major changes are needed.' Then and now, about 60 percent of the public feel dissatisfied with the current health insurance system. Yet three-quarters are satisfied with their own health insurance - once again eerily parallel numbers."
He elaborates: "There's one...number that I have to highlight - the three-quarters that say they are 'satisfied' with their own insurance. Most are not at all satisfied with a system that has forced them to trade higher wages for continued health insurance coverage and other compromises. But those personal compromises to get satisfactory coverage will mean people can live a little longer with the status quo, and (they) want to make sure the proposed changes really will make things better for their families."
So the burden of proof is clearly on Obama to make a compelling case for reform.
Greenberg also finds, today as in '93, that Americans' general enthusiasm for health care reform is tempered by their skepticism toward government: "Yes, we're no longer living in the shadow of Ronald Reagan. But the country has maintained the same anxieties about government's ability to improve the system. The country divides evenly (in his new polling) on whether the greater risk is an unchanged status quo or government reforms that 'create new problems.' And, finally, Obama might want to pay attention to how closely his situation echoes Clinton's. Then and now, more people favor the president's health care plan than oppose it, but the supporters make up less than a majority. If anything, I found on most of these questions that the desire for change and support for reform was slightly stronger 16 years ago..."
As Greenberg makes abundantly clear, Obama's daunting challenge is obvious. People typically take a NIMBY approach to the health care reform issue. They generally support the concept, but if they come to believe that their own costs might go up, or that their own treatment options might be affected, or that the plan might require higher taxes on something, then they are prone to simply say "not in my backyard." Such was the Clinton experience in 1993 and 1994.
"And those dynamics are still in play," writes Greenberg. "In my recent polling, I found that voters are skeptical about claims that reform will reduce costs and personal health outlays. Claims about simplicity, information-technology modernization, and best practices don't seem to be enough to persuade them otherwise....And, while voters have great confidence in Obama and his administration, they are worried about the deficits and spending and the government bailouts of the irresponsible. So, while voters want to see a re-balancing away from greed and toward the public good, almost half the citizenry is worried the government may get it wrong."
And, going forward this summer, the Republicans can potentially exploit that worry with their own warnings about "government-run health care." As in this new video, for instance.
Granted, the Republicans have virtually nothing substantive to offer in this debate; granted, these days they are largely discredited as stewards of governance; and granted, they have little to say beyond saying No. But, if Stan Greenberg is right, a message of No might be enough to sow a sufficient amount of doubt. All of which means that Obama will soon be tested as never before.
@ 11:44 AM
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127 comments
Comments (127)
I saw a television report about healthcare reform. A commentator made an interesting report about the different parties vying for conflicting interests. None of them will accept less to make a system overhaul work. Insurance companies do not want less profit. Doctors do not want less wages. Patients do not want less quality care. The malpractice lawyers don't want limits on awards, etc., etc. Good luck with finding the common ground. Maybe banning aborting gays with guns who want to marry and smoke cigarettes instead??— Phrossty- I saw a television report about healthcare reform. A commentator made an interesting report about the different parties vying for conflicting interests. None of them will accept less to make a system overhaul work. Insurance companies do not want less profit. Doctors do not want less wages. Patients do not want less quality care. The malpractice lawyers don't want limits on awards, etc., etc. Good luck with finding the common ground. Maybe banning aborting gays with guns who want to marry and smoke cigarettes instead??— Phrossty
- I have difficulty believing that 46 million Americans are 'satisfied' with not having any health insurance at all. And, Obama's political team is far more seasoned, experienced, and intelligent than Clinton's was. Yogi also said "It ain't over till it's over..."— Yersinia Pestis
- Your post emphasizes some important facts, especially that 3/4ths of Americans are generally happy with their insurance. At the end of the day, there are generally more healthy people who don't need much of their health insurance than there are patients who frequently require health services. As a result, the emphasis is on "status quo" and low monthly premiums because there are more non-users than users. It is also interesting to note that while many of the uninsured Americans want health insurance, there is also a significant percentage of uninsured Americans who do not want to pay a penny for health insurance because they are "healthy" right now and don't see an urgent need for personal health insurance. I share Mr. Polman's concerns that major health reform will be extremely difficult and that the Clinton attempt is an important warning. However, I think the one major difference that Obama is proposing is that Americans can elect to stay with their existing coverage under his new system. Thus, the great majority of people who are "satisfied" can remain "satisfied". The Clinton plan was an all-or-nothing leap into the world of single-payer insurance. The notion of handing an additional 15% of the economy to government management (as would've been the case under the Clinton plan) makes even me concerned. The Obama plan is more incremental and it is highly unlikely that the public plan option in Obama's proposal will end up being the only option (because it would mean that all the private health insurance went out of business). Also, he has the Democrat majorities to ram this through even without Republican support.— Nalaka
"Americans have to be willing to take a calculated leap into the unknown." What unknown? You mean President Obama doesn't have all the answers to give us. I think the news media can help here. Let's say ABC News do an infomercial on health care "reform". They can do the nightly news from the White House, then have a town hall meeting with the president so he can talk directly with the American people. Oh, and don't invite any of those anti-reform, status quo types. They'll just interfere with Obama making our lives better. Darn it! I just checked Drudge, it look like ABC beat me to the punch.— jmc
Comment removed.- Ronald A. Williams Chief Executive Officer Aetna Inc. Insurance Health & Disability In 2007, Ronald A. Williams raked in $19,924,027 in total compensation. In the previous year the CEO of this company made $32,158,245. Total CEO compensation has decreased by 38%. Nobody is worth that much pay , NOBODY! And we wonder why healthcare is sooooo expensive!— hejira33312
- 75% of American are satisfied with their health care. Nuff said there. The 46 million number is a over blown. 40% of those people are ILLEGAL ALIENS. Another 10% could have coverage but choose not to take it or don't know they are qualified for it. There goes almost half right there. Obama says that people who are happy with their coverage can keep it. What he is not saying is that he is going to tax your employer who is providing that coverage. This will lead to it being dropped forcing you into the public coverage. Also he will have to raise taxes to pay for it, no matter what he says. The math does not work out. Then please look at the state of England's heath care before you go rushing into this.— DadofThree
- 75% of American are satisfied with their health care. Nuff said there. The 46 million number is a over blown. 40% of those people are ILLEGAL Aliens. Another 10% could have coverage but choose not to take it or don't know they are qualified for it.. There goes almost half right there. Obama says that people who are happy with their coverage can keep it. What he is not saying is that he is going to tax your employer who is providing that coverage. This will lead to it being dropped forcing you into the public coverage. Also he will have to raise taxes to pay for it, no matter what he says. The math does not work out. Then please look at the state of England's heath care before you go rushing into this.— DadofThree
- "Nobody is worth that much pay, NOBODY!" ««--- Scott Boras would disagree with you. (So would Oprah, Gates, Cosby, Soros, Buffett, Larry Ellison, The Walton Gang...)— Phrossty
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- DadofThree— Tony_From_PA
- DadofThree: ahave you ever been to England?— Tony_From_PA
- Health care is expensive for two reasons 1) Colleges rip people off by charging tutiton rates that are ridiculous (so they can pay tools like Polman) as writer in residence and 2) the lawyers in this country make a killing off of frevelous malpractice law suits that insurance for doctors is extremely high because of lawyers, tha same type of lawyers on capital hill right now writing this universal health program.— reddog44
- Nobody is worth that much pay, NOBODY!" ««--- Scott Boras would disagree with you. (So would Oprah, Gates, Cosby, Soros, Buffett, Larry Ellison, The Walton Gang...) All these people are self made or inherited their wealth (that now that is a mistake). Most CEO's are just self serving schmucks who keep driving their companies into the ground by focusing on the next quarter.— Tony_From_PA
- I don't think the populace realizes how the government have messed up the healthcare system we have let alone give them more power to mess it up even further. Insurance mandates put in place by the government are from the effect of lobbysist groups influence on congressman. This means they make insurance cover such idiotic things like marriage counseling. Not allowing insurance to be bought accross state lines eliminates the market forces necessary to cut insurance costs. Government will not be a solution to this problem. Rest assured on that.
- The costs of insurance are so insane right now, it's getting hard to keep up. My place pays mine, but to add my wife & child is $1250 a month. I don't begrudge the work place -- they see increases of 60% a year! And healthcare insurers can't even get punished like other carriers for their indifference. They're not subject to state law regulation like every other type of insurance. If they just eliminated the state law preemption provisions of ERISA, it would be a start.— etotheb
- you know pollman. the entire article was well written, showed the competing angles and intrest and potential conflicts. Too bad you had to let your hard core bias close in the last paragragh. You lost credibility .— stevejones
- stevejones, you mean this statement of fact: "Granted, the Republicans have virtually nothing substantive to offer in this debate; granted, these days they are largely discredited as stewards of governance; and granted, they have little to say beyond saying No." ?— PA_Dutch
- Dadofthree: IF your numbers are accurate (source?), then 60% of 46 mil is 28 mil. Then 90% of 28 mil is 25,200,000. So you're okay with 25.2 million Americans going without insurance? And as for our taxes being increased, we will still save money in the long run, because whether you know it or not you and me are already paying for 46 million uninsured people. I'll take Britain's system over ours easily.— p-diddy
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- jwad: You'd rather pay a private healthcare industry that will soon increase their premiums into the double-digits? My point is that we're already paying for the uninsured. And we haven't even mentioned the under-insured, which are legion. This is now a severe burden on middle class people.— p-diddy
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- jwad: People who aren't working? Funny you should mention that. Those lazy unemployed! Oh the burden!— p-diddy
- link to insurance company excs pay http://www.aflcio.org/issues/healthcare/upload/hc_ceosalaries.pdf— hejira33312
- p diddy- then you pay for it! Get out of my pockets
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- "Granted, the Republicans have virtually nothing substantive to offer in this debate; granted, these days they are largely discredited as stewards of governance; and granted, they have little to say beyond saying No." Dick, you're being lazy and simply feeding into the generalization that the GOP hasn't offered anything. You do know that several Republican congressmen have already proposed legislation, right? Read through The Patients Choice Act instead of googling Sarah Palin.— Vandy
- I have been to England, and have relatives who live there so I do know what I am talking about. Those who can afford private insurance get it rather than to go into the government plan. Most of the politicians have private insurance. I am not OK with the 25.2 million not insured, but this plan is not the answer. Find out what hole in the system these people fit and fill it. I guarantee it would be cheaper than this and not ruin what good we already have. You are all talking a good game to but guess what else England had to pay for it's system. Take a look at it's income tax brackets. Let see how eager you are when it comes time to pay for it.— DadofThree
- The net result will be you pay more for own insurance and you will pick up the tab for others as well.— ncatty
- I've been to the U.K. as well as many other countries in Europe and everyone over there thinks the U.S. model is insanity. If people want to pay for private insurance, fine, but having coverage for everyone stabilizes the society. Also, I, and most people I know, have no problem paying for the added benefits to society. The private sector has ruined health care in this country. For all the right-wingers out there, why not go out, open a business, and buy a doctor? That's your system. For the rest of us, we need a serious overhaul.— HandNik
- The last line in Polman's column is ridiculous. By stating that Republicans have no solutions other than "no" means Polman just doesn't have his ears open. How about allowing consumers to buy from any provider regardless of where they live, how about we eliminate the mandates on what insurance must cover, how about we allow small business to form a buying association, how about we limit payouts on malpractice claims, how about more options in insurance coverage?
- $1 trillion to cover 20 million people. Only a loony, state-media "journalist" like Polman would whine that the repubs are the party of no for questioning where that money to going to come from.— CD75
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- Can we send Bono from U2 to China to have him negotiate forgiving our debt?
- the point is we are the only civilized nation in the world that doesnt have a universal plan and the reason is the people making all the money have the dems and repubs in their back pocket, the other countries populations are not marching in the streets for change but we should be!— hejira33312
- Nalaka--you're wrong that the Clinton plan was single-payer. Somehow, the opposition planted this idea and it stuck. The Clinton plan was based on private insurance, modeled on the German system,.— liberal
- hejira33312- Why would you want to be like the rest of the world when we have the highest standard of living in the entire world? We are the only country in the world where our poor people are obese. The evidence of how poor the healthcare is in these countries that universal healthcare is overwelming. It does not work. In fact the meddling that government has already done in our healthcare has messed it up. Why would you want to give this government more power over your healthcare? The reality is that Obama and the libs do not care about your healthcare. They care about power. They care about making you subservient to the government. They care about getting re-elected. Liberals have all been brainwashed.
- The problem with public attitudes is that the public doesn't really understand health care and insurance. First of all, everybody, except for the extremely rich, needs health insurance, since they cannot possibly pay out of pocket for a catastrophic illness. To mention two instances involving my own acquaintances, a routine premature delivery runs over $200,000; an organ transplant can go into the millions. These things can happen to any of us and we must insure against them. The problem is that many people can't afford or won't buy insurance. Thus, the insured people pay for the catastrophic care of the people not in the system. Of course we could let them die, as would have been the case in pre-Christian times, but we're just not going to do that, so forget it as an option. What's the point of saying that such and such percentage of the uninsured are illegal aliens? Are we going to let them die in the street? Would we want to patronize doctors who would do that? As insurance gets more and more expensive, fewer people have it and the system starts into a death spiral. Universal coverage is essential so that everybody pays in. The second point is that health care is not a commodity that fits into the market system. Nobody saves up for a liver transplant. The determination whether to have expensive procedures is made by the health care provider, not by the consumer of the services. So the consumer has no way to shop for the best buy. Next time you have chest pains, are you going to google cardiologists and find out whose rates are lowest? A fantasy. Health care has to be provided on a collective basis (not necessarily by the government) and it must be equally available, like police or fire protection, or the services of the Army, Navy, and Air Force. In most systems, people who can afford it can have private doctors or private insurance if they want to elevate themselves out of the regular system, and that's fine.— liberal
- swede--you keep repeating that countries with universal health care have poor coverage, that the evidence is"overwhelming." Where are you getting this overwhelming evidence? Not only do most developed countries have better health statistics than ours while paying less for health care, but everybody I know who has actually experienced the systems in Europe has had experiences that are at least as good, and usually better, than they have here. Is there some secret fund of evidence that you are relying on? Rush Limbaugh?— liberal
- kelprod1--you say no health insurance until we can finance it to the penny forever. Did you say the same about the Iraq war? Or any other government or private venture for that matter. Such a test is impossible, since we can't predict the future.— liberal
- I'm just happy that Mr. Obama is taking care of everything. He is such a great man and all of his policies deserve a chance. This is exactly the Hope and Change I wanted. I cannot wait until everything in my life is dictated to me so I won't ever have to think again.— CA Scum
- reddog--nobody wants to defend overly-aggressive malpractice litigation, but the effect on health costs is probably minimal. Recent studies in Texas, where malpractice litigation is greatly restricted, show some of the most abusive Medicare overcharges and excessive procedures.— liberal
- Has anyone noticed Obama gingerly beginning to distance himself from the "95% of working families won't see ANY tax increase" pledge, as people finally start thinking about how we're going to pay for all this stuff? A Bloomberg story this afternoon..."One of the biggest variables in this whole thing is economic growth,” the president said in an interview with Bloomberg News at the White House. “If we are growing at a robust rate, then we can pay for the government that we need without having to raise taxes.” -- http://www.bloomberg.com/apps/news?pid=20601087&sid=akaJVOByDsHg— Vandy
- We need a single-payer system. If Obama is unsuccessful in at least getting a public option, the system will continue to become more and more dysfunctional, more and more businesses will go under, putting our country at a competitive disadvantage to more advanced countries, and more people will be unable to afford coverage, hitting the rest of us in the pocketbook, while insurance execs rake it in, spinning off a few dollars to contribute to friendly pols ... and someday enough people will understand to back the socialist option. Most people can't make such hard decisions until the pain is unbearable. We're probably not there yet.— Djoko Pritza
- Obama keeps talking about providing all Americans with the same gold-plated coverage that Congress gets. That may be the insane thing he's said on that front...we'd be broke within 10 years. Instead, why not make it like car insurance, eliminate inter-state restrictions, and make room for the "800-SAFE-AUTO" equivalents--the high-deductible, bare-bones policies that the healthy young adults who choose not to buy insurance now can have to protect them against catastrophes. After all, that is the true objective of "insurance," right?— Vandy
- "We need a single-payer system. If Obama is unsuccessful in at least getting a public option, the system will continue to become more and more dysfunctional." Completely disagree. Government monopolies are hardly the best answer to anything. How many times must the taxpayers bail out Amtrak, for example...or the auto companies now, for that matter? And for goodness' sake, in the wake of the debacles of Barney Frank's precious Fannie and Freddie, do you think there won't be any graft or corruption under that system???— Vandy
- Government run healthcare leads to rationing and cost benefit analysis style of care. Providing government insurance without rationing leads to higher costs as those who were previously not insured now seek medical treatment, physicals, etc...leading to higher usage and thus higher costs, which leads to rationing of care. Right now, we do not have enough doctors, hospitals or labs to take care of all the newly insured, so care will need to be rationed...leading to longer wait times before seeing your primary care provider, a hospital bed, lab tests, or surgery. Obama wants to reduce payments to hospitals and doctors under Medicare, which will lead to higher costs for the insured, or cause people to leave the profession, or opt out of Medicare/Medicaid (as Walgreen's did in Delaware when the state lowered reimbursements and several and some physicians are doing). Government run health care will also lead to increased chance of error in diagnoses, causing higher use of "defensive medicine", leading to more wait times for medical services. I know this is all from a conservative and a member of the party of no, and perhaps an angry old white guy, but there are (much to the dismay of Polman and p-diddy) alternative options. One is medical co-ops, which is being floated by a truly bi-partisan group in the Senate..and Obama wants bi-partisanship...right? Besides, the CBO already said a government run option will cause 22 million people to lose their current health care and be forced into the gov't plan. Lastly, people are happy with their current health care because they know their doctor, they can get treatment relatively quickly, and they know their costs. With a gov't run plan, and the higher taxes that go with it, it is all a guess.— tom - wilmington, de
- handnik...I too have been to England. The people I know, and the cosnervative British politician Daniel Hannan, all say we would be nuts to go to a government plan. Why is Canada and other countries going more to private clinics and coverage? Canada is even thinking of unraveling their government run plan.— tom - wilmington, de
- Cool. Latest from Gallup....40% of those asked consider themselves Conservative, 35% consider themselves Moderate...and only 21% consider themselves liberal. By party, 22% of Democrats consider themselves Conservative, 40% Moderate, and 38% Liberal. How about the all important independents? Funny you should ask. Independents are 34% Conservative, 45% Moderate, and 20% Liberal. This may explain what no Liberal is willing to admit...why Obama is more personally popular than his policies.— tom - wilmington, de
Health care is a fundamental human right like housing is. We should do our best as a society to make sure that the basics are covered for the indigent and incompetent, the wards of the state. Like public housing projects, the states and the Federal government should provide access to free government clinics in each state. The clinics can be staffed at minimal salary by doctors in training, or by doctors who aren't accepted by private health care facilities, or by kind hearted volunteers who believe in health care being a fundamental human right. This can be done for $10 billion per yea, and the level of care will be superior to what even the most affluent had only a generatio ago. But don't make the entire country live in public housing.— Mr. Smith- Vandy 6:52--I think you are starting to get it. Health insurance is more like car insurance than it is like a welfare program. Conservatives want for some reason to brand universal health care as some kind of hugely expensive government giveaway to the undeserving when in fact it is primarily a correction to a market failure; a good program, like good car insurance, will end up costing us less.— liberal
- One thing I don't see here is addressing the spiraling costs of the existing system. Few will be able to continue with medical insurance at the current rate of increase. I'm against the governmnet becoming the arbiter of care but there needs to another tier of care because we're paying a premium for those who get dumped at the door without any coverage.— JimR
- Well, gee, we're letting Obama run the banking and car industries. Why not let him run the health industry. He's worshiped like a God by the left. What could possible go wrong with our entire economy being run by Obama and his leftist elites?— mistermcfrugal
- Tom, I get my health insurance through my company and I would consider it extremely good but a few years back my doctor ordered a specialty cardiac test and the carrier (through an outsourced 4th party!) required a cost analysis to justify it. My doctor went through the roof on this but the 4th party said they and the carrier needed to balance costs. One of my kids was sent a video of exercizes to try because the carrier didn't want to pay for an expensive prescription for a back injury. We are getting rationing and cost analysis vs. human care right now. I don't want the government involved in this any more than the rest but decisions are being made now on the basis of profit and bonus schedules. In most areas, car insurance is mandated to cut down on the overall costs of the system. we are going to need to have everyone covered somewhere along the line.— JimR
- "Conservatives want for some reason to brand universal health care as some kind of hugely expensive government giveaway to the undeserving when in fact it is primarily a correction to a market failure; a good program, like good car insurance, will end up costing us less." But car insurance companies are private entities; the Democratic answer isn't removing the barriers to private competition in health insurance, it's providing a massive "public option" initially that paves the way for the single-payor system Djoko craves. That's the complete opposite of the car insurance example.— Vandy
- Judging by the 5 million that Aetna and Amgen gave Senator Kennedy my judgment is that the benefactors of the Health care bill will be Amgen and Aetna. Those of us who bothered to get a job and do it well will be forced to pay for the slackers. Eventually we will all be in some government run healthcare plan. Not to bring down the party but that is what will happen. And just like the governments cost predictions are never right the actual cost will bankrupt the country and force us to suspend any military spending. Eventually we will all speak another language.
- In the spirit of transparancy does anyone know what a Czar makes?
- What Mr. Polman left out is, Obama has yet to achieve very much. Why should we trust him in a "leap into the unknown"? Indeed, if Mr. Polman wasn't in the Tank for Obama, he might use a little skepticism... Obama's record for ANYTHING in a business arena is dismal. The Stimulous package was full of Pork by a factor of about 3:1 - If Obama is that good with Healthcare we'll double our costs. Mr. Polman should try some journalism in these matters, and stop running apologetics for Obama.— BillSanford
- Smike, Aetna buys influence in the free market. If they are buying Kennedy influence, what is their interest in losing their market? BTW, AMGEN is a biotech, they aren't going to get much traction in a socialist medical system.— JimR
- JimR- But why the 5 million to Kennedy's charity? There was an article last week about how congressman now circumvent lobbying rules by setting up a private charity that lobbyist contribute to. Kennedy lead the pack with 5 million in contributions. Are we to believe it's all about charity? That money is about currying favor. Or lets just call it what it is. A friggin payoff so that they profit from this healthcare bill. Aren't you just a little suspicious of this?
- Let me try again. In the spirit of transparancy can anyone tell me what a czar makes?
- If any of you remotely believe the cost predictions for universal healthcare then you must also believe in unicorns, mermaids, and fire breathing dragons.
- swedesboromike: "Those of us who bothered to get a job and do it well" ARE already forced to pay for the "slackers". How do you think hospitals recoup the $$ for uninsured patients (now that the federal government and states have slashed those reimbursements)? By charging you $7 for an aspirin, that's how. Why do you assume that only "slackers" don't have medical insurance? Listen, for those who are unemployed, it's either Obama's fault or they are lazy. Please pick one and stick with it. And from your earlier post, malpractice awards are only a small percentage of health care costs, and not really responsible for the cost growth. I agree about allowing small businesses to pool together - it's legal in many states (although "adverse selection" tends to break up the pools).— still_independent
- Still Independent- You are looking in the wrong place for a solution. What you will get and I can promise you this is a giant bureauracy to run it, higher taxes to pay for it, and no results to show for it. As sure as you will continue to pay taxes I can assure you the cost will be much more than predicted. No liberal solution has ever worked and I question wether you really want your solutions to work. I think it has more to do with power than anything else.
- I'll try a third time. Can anyone tell us what a czar makes ???????????????????????
- Still Independent- Hospitals are never going to turn people away at the emergency room. Universal healthcare will not lower this cost nor will it limit traffic at the emergency room. Because this is still the land of opportunity thousands cross illegally every day. Will universal healthcare cover these people as well? And just where do you think they will go if they have a crying two year old at 2am with an ear infection? shall they have to wait 3 days to go see the doctor or get the matter resolved immediately at the emergency room? You think this is going to be this utopic experience where the doctors are brilliant and the care is stellar. Trust me when I tell you that you will drive costs up, drive doctors out of the profession, and you'll still be bit**ing about this topic 20 years from now.
- swedeboromike: the salaries of the White House staff are usually released the following year, so look in 2010. Those with the title "Assistant to the President" usually make the most. In 2006, 19 people in the White House made the top bracket (including everyone's fave, Karl Rove) - $165,200. The salaries are at the discretion of the President, so long as he operates within the confines of executive budget established by congress. The White House is not required by law to make public any complete accounting of staff or individual salaries. They SHOULD, in the interest of transparency, do so. In 2008, the top bracket was $172,500, and I believe Obama announced a pay freeze for top aides, so I would ASSUME that the most a non-cabinet level czar (such as the "drug czar") would make would be $172,500.— still_independent
- Still Independent- Don't you think that the cabinet appointments should be doing the jobs of the czars instead of adding cost by creating new postions? Obama has more czars than the Russians ever had
- swedesboromike: you're missing the point. You are paying for the uninsured now. You say "liberal solutions" don't work. Fine. What is the "conservative solution"? Unless you are unwilling to accept that everyone should have access to health care, then what is the solution? Unlike some, I am willing to listen to ANYONE's ideas, allow them to present them, and weight the pros and cons accordingly. What I don't want to do is watch people spout off about things like malpractice insurance that aren't the problem, and will not fix the problem. I'm sorry, but during the campaign, I found McCain touting the free market solution as completely ridiculous - as a multiple-melanoma surviving septagenarian, he would be uninsurable in a completely free market system. If your utopian situation is that those of means get health care, and those without it don't, then the disconnect is in the goals of the system, not how to get there.— still_independent
- 3 million dollars to help the homeless in Union NY in the Stimulus. Problem is Union NY never asked for the money and doesn't have a homeless problem. Turtle crossing tunnels at a cost of 7 million. oh wait it gets even funnier when you watch the turtle go around the tunnel on the fixed camera video. And why exactly did we need to rush to sign this and where is Joe Biden preventing the waste? Oh the transparacy.......sigh... And 10,00O stimulus checks went to dead people. I guess Biden was sleeping and Obama was picking his final four teams.
- The ER care at a hospital makes the case for a system of insurance for everyone. Through a clerical error(OOPS!) I lost my insurance for almost six months. No visit to the specialist to take care of my normal problem. Doctor's office (wouldn't see me without insurance) told me to go the the ER if I had any severe pain. I asked a neighbor who does admissions what the costs would be. I'd have to sign responsibility for up to $5K (assuming I wasn't a Medicade case) If I had insurance, they'd accept the fee schedule from the carrier. The numbers aren't real and the hospital would "cost shift" to cover my cost. So, there would be no attempt to keep me out of ER by preventative medicine and the lower my ability to pay, the higher the cost. Something's wrong here.— JimR
- swedesboromike: in all seriousness, what's the difference between a "czar" and any other advisor to the president? I don't think the federal gov't should be doing half of what it does now - but calling someone a "czar" is sort of arbitrary. Couldn't we call the "Assistant to the President for Communications", whatever the f@#$ he does, the "Communications Czar"? What's the difference?.. And it's a nit, but he has more czars than the Romanov's, not the Russians.— still_independent
- Smike, there's virtually nothing available about czar pay. It isn't required by law. In the interest of the transparency promised by the Obama campaign, listing the pay for the non cabinet advisors is a minimum requirement. More inside the beltway politics.— JimR
- Now this, a column from noted liberal Bill Maher, is what I was talking about when I asked the liberals on this site if this was the Obama they voted for...check out the LA Times link...http://www.latimes.com/news/opinion/commentary/la-oe-maher12-2009jun12,0,7966784.story— tom - wilmington, de
- "Unless you are unwilling to accept that everyone should have access to health care, then what is the solution?" Make health insurance like auto insurance, but eliminate the inter-state restrictions and thus allow for the 1-800-SAFE-AUTO equivalents. Obama wants to give everyone a gold-plated insurance plan, but what I'd argue is needed are the bare-bones plans to be offered alongside the more comprehensive plans, with tax credits to help those who need it. The idea of insurance is to protect against catastrophic illnesses, and if you can provide the "we keep you legal for less" options to, for example, healthy young adults who currently choose to forego insurance, you can go a long way towards making affordable insurance available for everyone.— Vandy
- Still Independent- Malpractice is a big problem in medical costs. Philly magazine did an article on it a few years ago where a lawyer included a doctor from the philly area in a lawsuit so he could get the venue moved to our area because jurors tend to side with the plaintiff. Problem was the doctor in Philly treated the patient for something unrelated to the complaint. The doctor in question was from Allentown but they took whatever measures to get the venue moved to the area where the chances for awards would be greater. If you have health insurance you pay for that. Beyond malpractice the solution lies in allowing buying associations, allowing purchasing from any provider regardless of geography and with that you will get more choices. For example a healthy 25 year old might opt only for a lower cost catostrophic policy and just pay out of pocket if they have strept throat etc. There are other solutions that would be more cost effective and be less of a burden to the government and the taxpayers. My fear is the cost overruns and inferior care will further hamstring our country
- tom: since you always question "Is this the Obama you voted for", I'll point out two recent things that I didn't like (and again, i did NOT vote for him). #1 - during campaign, he said he'd work to overturn the defense of marriage act. now he allows DOJ to file a brief in support of it. #2 - allows secret service to continue to classify white house visitor logs ( a practice started by Bush).— still_independent
- Tom, this was funnier when Maher did it as his weekly rant than in print. It's a good point that Maher made but, will conservatives accept the trashing that he put on Bush towards the end of the rant? He paints GWB as a complete moron. He's always over the top.— JimR
- swedeboromike: you can throw out little anecdotes all you want, but according to the CBO, malpractice accounts for less than 2% of health care spending (at least as of 2003). And that included ALL malpractice, valid or not. They also shred the "defensive medicine" argument. In 2004, from the CBO : "... CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts."— still_independent
- yes, it's the obama i voted for; do i like everything he's doing, or not doing? no ... but i'll give him the benefit of the doubt in the short term; he's so much smarter than anything we've seen in office since, maybe, eisenhower, and he'll learn on the job ... i'm happy to give him time ... it's the bozos on the right who would flush the country down the toilet ... look at mccain, wants to talk tough to iran; we just got rid of eight years of tough talk that got us nowhere ... calm down, tom boy— Djoko Pritza
- and bill maher isn't my idea of a role model ...— Djoko Pritza
- Still Independent- Any doctor would disagree with you. And really you are going to give me CBO numbers? Is this for real? The CBO numbers are notoriously wrong. furthermore 51% of Doctors recommend invasive procedures lke biopsies more often than they believe are medically necesary. Doctors become more secretive, talk less openly with patients and become averse to acknowledging any mistake. Insurance premiums rise and both doctors and hospital pass the cost on to patients.. Newly feaful, the medical device mfg decides to stick to proven technologies, doppring its plan to pursue a new line of tools tha would make surgery less painful and less risky. Get the idea?
- swedesboromike: you continually quote CBO numbers for Obama deficits and lower growth expectations, but that's besides the point. OK, since you don't trust the non-partisan CBO (and the study was done under GWB and a Republican controlled congress, btw), where do you get the "51% of Doctors recommend invasive procedures lke biopsies more often than they believe are medically necesary" statistic? This is why no one answers your questions. If presented with any data that contradicts what you "know", then you completely disregard it, regardless of the source. OF COURSE doctors are for tort reform. OF COURSE doctors sometimes perform marginally necessary procedures - they get PAID for them. Here's a question for you - from what source (besides Rush) would you accept data that showed that malpractice doesn't really affect healthcare spending? My guess - you wouldn't. I won't bother to show you statistics that showed malpractice insurance rates rising even when malpractice payouts didn't. You'll just ignore that, too.— still_independent
- George Will brought out an interesting statistic this past Sunday in a discussion with Donna Brazille. About the "47 million" uninsured. In the US Census report “Income, Poverty, and Health Insurance Coverage in the United States: 2005,”, the breakdown of the 47 million includes approximately 9.487 million illegal immigrants (undocumented workers); 8.3 million earn between $50,000 and $74,999; another 8.74 million make more than $75,000. Now, since most of these people fall in the category for their kids to be covered by SCHIP in most states, perhaps they choose not to have health insurance even though they may be able to afford it. Also, according to Cheryl Hill Lee, a co-author of the Census Bureau report, they actually “underreported” the number of people covered by health insurance – meaning that more people have insurance than the report suggests. The Census also underreported the number of people covered by Medicare and Medicaid." Besides, if the government option would play by the same rules as the private carriers, and there are already more than 1,300 private health insurance providers to offer choice, why have a government option in the first place?— tom - wilmington, de
- JimR...Maher always trashed Bush. Conservative do not have to accept or reject Maher's criticism of Bush since he is no longer President. It is also nice to see Djoko is getting what he voted for...so when the s$$t hits the fan, the US loses its credit rating, Iran nukes Israel (after all, we wouldn't want to meddle in Iranian policy), the deficit hits $20 Trillion by 2015, unemployment gets over 11% (Obama is now saying it will be 10% by years end), and with higher taxes and too much government regulation this recession never ends, he can sit back and say "Good job Barry". Thanks djoko....— tom - wilmington, de
- Still Independent- You couldn't convince me that the cost of malpractice insurance is major factor in healthcare cost. I get my info from two Doctors who are friends. The yearly premiums on the insurance are huge. There are a lot of competing factions like the trial lawyers association who reap huge rewards and have staked their careers and livliehoods on these cases. My point being that the stats are greatly influenced by special interests. Just like Amgen and Aetna are buying influence with Ted Kennedy you can bet that the trial lawyers lobby does not want any tort reform and will use whatever means necessary to influence the statistics. Actually the more I think about this multi billion dollar healthcare industry and the money the players and profiteers have paid elected officials the less I believe that anything will get done. The whole thing could be DOA.
- Still Independent- Sorry, meant to say you could not convince me that malpractice insurance is not a major factor in healthcare cost. The broader point here is that an opportunity for some low cost tweaking of regulations to drastically lower healthcare expenditures is going to lose out to the multi trillion dollar plans of liberals that will bankrupt the country if passed
- Smike, I am very suspicious of contributions to politicians. I'm curious about the logic that says Kennedy wants to turn the system over to socialism when he gets paid by the 800 pound gorilla of private health insurance. Kennedy is a crook - we're in agreement on that. Your argument doesn't add up. Besides, Amgen is a boitech company. They buy influence for local issues not national health insurance. Your point...?— JimR
- For the most part I really find our heath care system not as bad as proclaimed by politicians and the news media, It's at the point that you have to be naive to believe either, and that goes double for politicians. We have the best health care in the world, but it is not cheap. People come here from all over the world when the have a serious ailment. Government has never run anything well and all their programs suffer in red ink. Already they are involved in health care with Medicare, VA Hospitals, Medicaid, all in red ink after years of experience. To mention a few more government bottomless money pits, Amtrak, US Post Office and the DMV. I'm not in the medical field and even I know cost cutting can be achieved by limits on legitimate law suits, and elimination of frivolous law suits. Streamlining FDA regulations and group rates for everyone would also help. To some degree Walmart has already proven that it can be done.We don't have to resort another government run fiasco which we have to keep afloat with ever increasing taxes.— bobdin
- Jim R- The point being that Aetna and Amgen would have a vested interest in this healthcare bill and is paying to try to make sure that whatever happens their business will somehow profit. Aetna does not want 1-800-health Insurance and has paid 5 million dollars to Kennedy to make sure their profits will be protected. I kinda feel sorry for people who actually think politicians care about the people. They care about power and say one thing to the cameras and quite another while they are receiving payoffs from giant conglomerates out to protect their own interests.
- Bobbin- best post on the subject. I totally agree. All we need to do is allow buying associations and low cost providers to sell anywhere and we'll spend very little money to solve a problem. To wit with the facts that every entitlement program is broke, we'll take the trillion dollar plunge down another bottomless pit.
- swedesboromike: at least it's good to hear you admit that no amount of information/statistics/data, from ANY source, will convince you that you are incorrect if you already "know" something. We are done. You know what you know, and I won't let reality intrude on your happy place any more.— still_independent
- bobdin: why would you want to plasce "limits on legitimate law suits"? Aren't we supposed to be about accountability? You do realize that if a child is, heaven forbid, killed due to a doctor's negligence, there are almost no actual damages, outside of pain and suffering and medical costs that you can collect? There is no lost wages - maybe he would have been a CEO, maybe she would have been a slacker. I've never understood this.... As for "frivolous" lawsuits, who determines that besides a judge and/or a jury? I'm all for reform. I don't even mind loser pays, since most attorneys in this area work on a contingency basis. But to arbitrarily cap isn't the answer.— still_independent
- Bet you anything that all of the czars get paid a lot less than what Blackwater stole from Bushi's the Iraqi project.— Tony_From_PA
- Obama has been quoted in the past as having a long term goal of single payer healthcare like Canada and the UK but being aware he has to do it incrementally for political reasons. The lazy public and compliant media will not expose this of course. The so called public option is the Trojan horse that will start this process as employers will find incentives to dump their employees into that system. When the system gets big enough you will start seeing rationing and DC making medical decisions for you and your doctor, as it happens in those countries. A lot of people happy with their insurance now will be forced into government run insurance and lose what they have now. Rude awakening for lots of Americans. I am all for susidizing the people who cannot afford insurance now, regulating the industry so is obligated to offer affordable insurance for them, end discrimination for preexisting conditions, mandate everybody to have it so we have a larger pool, universal electronic records to make healthcare more portable and avoid mistakes and duplicated testing, radically change tort laws as they apply to doctors so they do not practice defensively.— jjfalcon35
- still_independent...yes, most attorney's work on a contingency fee basis...for the plaintiffs. Not for the defense. Loser pays would hold the plaintiff accountable for the defense legal fees if the suit proves to be frivolous by a judge/jury. Are you for that type of reform? As for jurisdiction, there are cases where attorney's try to get this moved to more favorable locales (like the Phila area) by pointing to even the most remote tie to the victim. As for the suits themselves, the case of a stillborn infant caused by doctor neglect is not frivolous, and no $$$ amount can be put on that loss. However, you cannot state there are no suits that should not be brought. Also, in PA alone, there are over 40 hospitals, maternity units, and medical facilities that have closed in the past 10 years due to the high cost of insurance. Many doctors in obstretics/gynecology have stopped delivering babies due to the high insurance, risk of problems, and possible lawsuits. While you may argue that actual lawsuits do not raise costs, you cannot argue that the fact doctors have stopped providing services, facilities have closed or stopped providing certain types of care, and physicians have left the field due to malpractice costs has not added to the medical costs inflation we are experiencing.— tom - wilmington, de
- Why has no liberal on this site, and even Polman, come out and talked about the CBO estimate that 22 million people will lose their employer provided insurance if a government option is included in the "reform"? Why has no liberal on this site talked about the taxing of health benefits, which Obama called imposing the largest tax increase on the middle class in our nation's history just a year ago. Why has no liberal on this site talked about the cost and for how it will be paid (lastest estimate is $1.6 trillion). How about Congress not wanting to use the "scoring" by the CBO but wanting to use "scoring" provided by the Obama admin to estimate costs? The silence is deafening.— tom - wilmington, de
- Anyone interested in health care reform and the need to do it now should read Peter Orszag's op-ed in the Financial Times. Good Read. http://www.ft.com/cms/s/0/6c0ec9ee-59d9-11de-b687-00144feabdc0.html?nclick_check=1— chasing history
- I would like to offer the President kudos for his remarks on what is happening in Iran..."These elections are an atrocity," he said. "If [Mahmoud] Ahmadinejad had made such progress since the last elections, if he won two-thirds of the vote, why such violence?" The statement named the regime as the cause of the outrage in Iran and, without meddling or picking favorites, stood up for Iranian democracy. Ooops...that was the French president, Sarkozy. Where is our president and his support for the "free and fair" elections? Wasn't it just last week that the press and even Obama himself at a press conference talked about how his speech changed the tone in the Middle East? Where is he now?— tom - wilmington, de
- Dick, is there a reason my last two posts have been blocked?— Vandy
- Comment removed.
- tom: yes, I am aware that's not how the defense gets paid (although wouldn't that be novel? ) and yes, I would be OK with loser pays, so long as the "frivolous" determination was well spelled out. Yes, some doctors have left - also keep in mind that PA not only has high medical malpractice rates, they are also in the bottom 15% or so in terms of physicians' pay (the last data I could find they were 44th lowest paying state). Again, according to most studies, including the CBO and GAO, malpractice contributes only a tiny percentage to medical costs. I don't know how you quantify the cost of doctor's leaving an area contributing to rising medical costs. ... Now, lowering malpractice rates and encouraging physicians to stay in an particular state is a worthy goal, and a dicussion worth having; it just has little to do with health coverage or the cost of medical care. Using the boogeyman of frivolous lawsuits has nothing to do with overall healthcare costs, although it does make for nice sound bites.— still_independent
- The cost of a hostile malpractice environment goes well beyond policy insurance cost for doctors and hospitals. The real cost is in the defensive practice of medicine which leads to unnecessary and repeated testing.— jjfalcon35
- The so called public option is the Trojan horse that will start this process as employers will find incentives to dump their employees into that system.....Wal Mart in PA has been doing that for years. They pay their employees so poorly, they qualify for state Medicaid.— chasing history
- tom: I keep seeing the 22 million CBO number - where is it? What were they actually analyzing? ... While every administration tries to push OMB numbers instead of CBO's numbers, I do think it's important for Congress to look at CBO's scoring (there were huge differences in the estimates for the costs of the prescription drug benefits, from what I remember).— still_independent
- jjfalcon35: actually, many large, independent studies (including the CBO) have looked into the defensive medicine claim as well, and found it to be statistically non-existent.— still_independent
- I am a doctor and i see defensive medicine played out every day no matter what trial lawyers and allies sponsored studies claiming to be independent say— jjfalcon35
- jjfalcon35: OK, I'll bite. what sort of physician are you?— still_independent
- Gastroenterologist— jjfalcon35
- Nobody here who is opposed to Obama's health insurance plan seems to be moving forward with actual studies, etc. It's just the usual talking points like "government doesn't do anything well." Never mind the studies showing the VA (along with the giant Kaiser Permanente HMO as having the best results in treating chronic illnesses. Besides which, Obama's plan is not a government plan--it reserves the major role for private insurers. The key is universal coverage. The government's role is just to mandate the coverage, not to provide it. Most European systems use private insurance primarily. Vandy--you don't seem to realize that the system you propose, based on car insurance, is exactly what universal coverage is. It might end up somewhat mangled by Congress but this is what the debate is about.l And finally, the old chestnut about malpractice being the culprit has been studied to death and never found to be significant in any study. This talking point is transparently intended to smear the trial lawyers who tend to fund democratic candidates and to sue big businesses. Let's cut the baloney about this.— liberal
- jj...what % of patients either aren't able, or don't pay you?— chasing history
- I probably see 2-3 patients a week who have no insurance and come with the intention of paying out of pocket. If I know thats the case, I ask them about their financial situation and most times I do not charge them anything for my consultation.— jjfalcon35
- "Vandy--you don't seem to realize that the system you propose, based on car insurance, is exactly what universal coverage is." I think I get it, liberal. The key difference I see is that I'm talking about increasing the breadth of private offerings (State Farm, GEICO, Safe Auto, Progressive, Allstate, etc.), while every Democratic healthcare proposal I've seen includes the introduction of a massive government-sponsored plan. There is no such entity in the car insurance realm, and THAT is why it makes so much sense.— Vandy
- "The key is universal coverage. The government's role is just to mandate the coverage, not to provide it." You do realize that this goes against the Democratic platform, right? You're basically supporting the Republicans' Patients Choice Act.— Vandy
- I ask them about their financial situation and most times I do not charge them anything for my consultation....OK. My impression in speaking with some physicians I know is that, on avergae, 25-30% of people either don't pay, or are unable to pay. I think this is probably a bigger issue for hospitals than individual practitioners.— chasing history
- That is true chasing history. When I see patients in the hospital I truly do not know who has insurance and who does not. I get to learn about it when the billing department tells me few days later after I submit my charges for service. I work for a large practice so these episodes get diluted and do not affect much our operations. We write most of those off. Most of the uninsured patients I see in my hospital are undocumented immigrants who come for care through the ER and by law have to be cared for. That is just my experience.— jjfalcon35
- The cost for a consultant like me to care for a non paying patient or even perform a procedure is not as much as the cost that patient represents to the hospital when you add the ER time, hospital bed, supplies, nursing, medications, daignostic testing and procedures. It is definitely a much bigger deal for hospitals. Operating a Hospital is extremely expensive and not necessarily becuase the just want to make a profit. Try to search for the cost of everything from gauzes, IV, tubing, monitoring equipment, CT scanners, medications etc and you will see. Even if we mandate hospitals to work for no profit and decrease physician salaries to 75-100k a year regardless of specialty or productivity, I am not sure you could make a significant diference in the overall cost of healthcare compared to today.— jjfalcon35
- Following up on my earlier posts, here you go, liberal: "The president and many others believe that the availability of a public option alongside private options for people who need health care is, is a positive thing," presidential adviser David Axelrod told CBS. "He is going to promote that as part of his plan."— Vandy
- jwad, swedesboro, Tom: Whatever job you guys have that allows you to post on internet message boards all day must be one hell of a job. I'm guessing that you are actually unemployed. I'm not mocking unemployed people, because being unemployed sucks, but it's another thing to talk about the unemployed as being lazy and undeserving of health insurance. Hey, I think we just touched feet under the stall!— p-diddy
- Here is the posting times for one of our posters who complains about the unemployed being lazy and deserving of no health insurance: 1:51pm, 2:53pm, 4:31pm, 5:18pm, 6:13pm, 9:14pm, 9:16pm, 9:36pm, 9:38pm, 9:40pm, 10:06pm, 10:07pm, 10:19pm, 10:28pm, 10:38pm, 10:51pm, 11:39pm, NEXT DAY: 6:47am, 6:52am, 8:25am, 8:32am. I don't know if this person has a job licking stamps or something, but I AM unemployed and I don't have time to post that often. The mental health effects of such frequent posting are another issue.— p-diddy
- I have to defend still_independent. The reason that data and facts are so important is because anecdotes and experience do not often tell the whole story. Defensive medicine simply isn't a huge part of medical costs. Those are facts. Of course doctors think that it does, I'd be shocked if they didn't, but the data simply does not support that view. Saying things such as "well I know what I know and I won't change my mind" may make you feel good about your opinion, but it doesn't lead to useful discussion or a helpful solution. Present me with data, not opinions, not anecdotes, but data, that disputes what I am saying and I will gladly admit that I'm wrong. I say gladly because if medical malpractice had a huge impact on health care costs, this problem would be far easier to fix.— kaylee
- Well kaylee then you have to send your memo to Obama who acknowledged himself to the American Medical Association the need to look into the malpractice issue so doctors would not have to practice defensive medicine. It is not the main issue, but it is one that affects doctors and if we will be asked to accept lower salaries we should also get lower costs and malpractice insurance is a good place to start.— jjfalcon35
- Of course he did. There is no way that Obama, giving a speech to the AMA, would not acknowledge it as an issue. He needs the support of doctors to get his plan passed. There is a difference, however, between something being an issue that is concerning doctors and something that is having a huge effect on the high costs of health care. Politically, something may need to be done. I am sure that there will be many politicians, from both sides of the aisle, discussing it as a major issue, especially if they are speaking to a crowd of doctors. I am merely stating that, according to current data, it isn't one of the major causes of costs. If you can disprove that, I am more than open to hearing your arguments. I recommend Dr. Atul Gawande's recent article in the New Yorker, The Cost Conundrum, as an interesting take on the issue.— kaylee
- The most quoted study on this issue , winner of health Economics award by Kessler and McClellan showed 5-9 % savings a year, 150-200 billion a year savings in todays world if we get to eliminate defensive practice of medicine. Other studies, sponsored by lawyers and their allies, disputed this fact. My experience as a doctor is it is real. Frankly, to study this rigorously you would have to follow two populations of similar patients randomized to care under doctors practicing in lawsuit paradise Philadelphia and another one under doctors in a setting where they cannot be sued or there is some other way of momitoring performance and assuring accountability. I do not think such a study has been done or can be done. Only a design like that would answer the question— jjfalcon35
- Fair enough. As I said before, I almost wish it were more of the issue, it would make things clearer. Although a savings of 9% a year would certainly be significant, it just seems that this issue gets far more attention and blame for our high health care costs than it merits.— kaylee
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Cited by the Columbia Journalism Review as one of the nation's top political reporters, and lauded by the ABC News political website as "one of the finest political journalists of his generation," Dick Polman is a national political columnist at the Philadelphia Inquirer. He is on the full-time faculty at the University of Pennsylvania, as "writer in residence." Dick has been a frequent guest on C-Span, MSNBC, CNN, NPR and the BBC. He covered the 1992, 1996, 2000, and 2004 presidential campaigns.
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