PoliticsA US National Health Care System?

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To: Brumar89 who wrote (23310)3/2/2012 10:26:13 AM
From: Lane3
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do you perceive some nefarious intent on the part of the Catholic church to take over US healthcare or something?

I don't know about an intent to take over US healthcare, broadly, but there sure is an intent to command certain healthcare policy. There is obviously an initiative in place to control access to certain medical treatments and religious control of hospitals is an effective way to accomplish that.

All this discussion of 'role in the community,' value-added, mixing functionality just seems like excuses to gripe to me. Now we have 'intent' appearing.

When one is trying to get a point across, it can be helpful to use different phrasing, different angles, in the hopes of finding one that will resonate. Role in the community, functionality, and intent are all about the same thing, just different ways of framing it. Added value is an economic concept, a discrete point.

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To: Lane3 who wrote (23311)3/2/2012 10:56:37 AM
From: Brumar89
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I only see an attempt to control healthcare within their own institutions. As in not performing abortions and not offering health insurance options for their employees that violates their religious beliefs.

Where do you see Catholic hospitals facilitating the Catholic church's commanding healthcare policy for the US?

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From: i-node3/2/2012 12:35:20 PM
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“The reduction in the number of pregnancies compensates for the cost of contraception,” Sebelius said. She went on to say the estimated cost is “down not up.” - Kathleen Sebelius


I think this is an intentional misrepresentation that someone ought to insist on the backup data for.

Most women who want contraception are getting it today. What you have to consider is whether the incremental cost to the health care system of making contraception "free" to all women will be covered by a reduction in the number of pregnancies.

It is likely that a few pregnancies will be eliminated by including contraception in insurance policies. But the cost -- e.g., $360/year for every insured reproductive-aged female in the country -- might run something like $10 or $15 billion/year. You would have to prevent an additional ONE MILLION pregnancies per year to cover that cost.

There are about 6 million pregnancies per year in the US. To make her statement true you would have to prevent one in six. Even though there are a large number (~500K) teen pregnancies each year, it is a ridiculous presumption to suggest that more than a fraction of those would be prevented.

I think this is a pants-on-fire lie.

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To: Brumar89 who wrote (23312)3/2/2012 12:40:55 PM
From: Lane3
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I only see an attempt to control healthcare within their own institutions.

Did you see the piece I posted to Tim about the network of hospitals, some of which are Catholic, all of which have acceded to the Catholic rules on abortions, etc? To the extent that they get into mixed networks, they can leverage their control greatly, way beyond their own hospitals. As more and more hospitals network...

If it's an intentional plan, it's a good one.

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To: i-node who wrote (23313)3/2/2012 1:05:26 PM
From: TopCat
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"“The reduction in the number of pregnancies compensates for the cost of contraception,” Sebelius said. She went on to say the estimated cost is “down not up.” - Kathleen Sebelius"

I didn't know pregnancy was a disease.

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To: Lane3 who wrote (23314)3/2/2012 2:20:23 PM
From: Brumar89
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Are Catholic hospitals somehow causing hospital mergers to prevent abortions ... with the idea that somehow there will ultimately be no institutions that perform abortions?

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From: i-node3/3/2012 1:02:02 PM
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From: Lane33/3/2012 2:01:38 PM
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The opening paragraph of this piece really resonated with me. I'm a big fan of intelligent debate. But that's not why I'm posting it. I thought that some might find the debate interesting.

Is Obesity The Government’s Business?
Posted on March 3, 2012 by lowcarbconfidential
God, I am tired of the level of discourse in the world today. It appears to me most ‘debate’ has descended to little more than character assassination and pithy sound-bites that might feed the heart, but starve the mind.

Here’s something different.

Intelligence Squared is a group of folks who put on Oxford-style debates. They poll the audience on a question, gauge their responses, and then let two teams of two people debate the topic for 40 minutes or so. Then the audience votes again. The side that changed the most minds wins.

I’ve listened to these shows for a while now, but recently heard one that you folks who stop by this blog might have some interest in: Is obesity the government’s business? This is from a debate held February 7, 2012 including:

  • Dr. Pamela Peeke, WebMD’s chief lifestyle expert, is a physician, scientist and expert in the fields of nutrition, metabolism, stress and fitness.
  • Dr. David Satcher served as the 16th surgeon general of the United States and published America’s first “Call to Action to Prevent and Decrease Overweight and Obesity.”
  • Paul Campos is a law professor at the University of Colorado in Boulder and author of The Obesity Myth: Why America’s Obsession with Weight is Hazardous to Your Health.
  • John Stossel, the host of Stossel on the Fox Business Network, has received 19 Emmy Awards and has been honored five times for excellence in consumer reporting by the National Press Club.
If you’ve got the time, I recommend listening, which you can by clicking here. And if you find the notion of an intelligent debate on other topics interesting, you can find a lot more at their website or their YouTube Channel.

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To: TimF who wrote (20704)3/3/2012 10:10:59 PM
From: greatplains_guy
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Better Than Death Panels
John C. Goodman
Mar 03, 2012

Previously, I wrote about a dangerous development: a proposal by former Obama administration officials to give doctors immunity against malpractice lawsuits if they practice medicine according to government sanctioned guidelines. That would give the guideline writers enormous power to ration care.

Doctors would be able to escape the pain, agony, humiliation and costs of lawsuits, but only at a very heavy price: They would have to deny you the care their training and judgment tells them you need. They literally would be choosing between saving lives and curing diseases and the comfort of being able to avoid all the unpleasantness of litigation.

Fortunately there is a much better solution to the problem of malpractice and to the much wider problem of patient safety. I think of it as "medicine without lawyers." Further, Florida may be the first state to try it out. More on that below.

As things now stand, the only way a victim of an adverse medical event can get compensation is by filing a lawsuit, enduring its trauma and discomfort, and trying to prove malpractice. Yet only 2 percent of victims of malpractice ever file a lawsuit. Fewer still ever receive any compensation. On the other hand, 37 percent of lawsuits filed involve no real malpractice. To add insult to injury, more than half the money spent on malpractice litigation goes to someone other than the victims and their families.

Despite this poor track record, the system imposes a heavy social cost—as much as $2,500 per household per year, including defensive medicine, at today's prices. And it may be making hospitals less safe than they otherwise would be.

The malpractice system distorts the incentives of doctors and hospitals by encouraging them to make malpractice events as rare as possible, even if they increase the number of other adverse events. As explained in our Health Affairs study, the system encourages doctors to order more blood tests and other procedures in order to reduce the risk of malpractice litigation, even though these procedures may put patients at additional risk.

Fortunately, there is an alternative. For the money we are now spending on a wasteful, dysfunctional malpractice system, we could afford to give the families $200,000 for every hospital-caused death. We could give every injury victim an average of $20,000—with the actual amount varying, depending on the severity of the harm.

How exactly could this work? We propose to allow patients, doctors and hospitals a voluntary, contractual, no-fault alternative to the malpractice system. In return for forgoing their common law rights to litigate, at the time of entry into the health care system patients would be assured that if they experience an adverse outcome, the provider institution will write them a check—without lawyers, without depositions, without judges and juries—no questions asked.

This proposal would take quality-of-care issues out of the hands of the legal system and put it in the hands of people who are best able to do something about it. Providers would soon realize that every time they avoid an adverse death, they will save, say, $200,000. They would come to view every life as equally valuable—regardless of whether the cause of harm is negligence, preventive steps not taken or an "act of God."

To pay off the claims, hospitals would probably purchase insurance just as they purchase malpractice insurance today. Insurers would become outside monitors of hospital quality and their premiums would reflect doctor and hospital experience. Those with higher adverse event rates would pay more. Those with lower rates would pay less. Further, if patients desired to pay an additional premium and top up their potential compensation—doubling or quadrupling the amount—they would have that option as well.

Under this proposal, state legislators would establish a commission to set the minimum compensation patients must receive for various adverse events. An independent commission (with patients, doctors and hospitals all represented) would regularly review hospital records and determine whether an adverse event has occurred in marginal cases. The decision to opt out of the malpractice system is a decision to accept these non-judicial parameters.

As radical as it may seem, the idea may be catching on. In Florida, a bill proposed by Senators Alan Hayes and Jimmy Patronis and backed by an advocacy group called Patients for Fair Compensation would replace Florida's highly litigious medical tort system with a new approach, modeled after the workers' compensation system. In this manner, Florida would implement a "no-fault" system that would compensate patients for certain types of injuries deemed as medical errors.

An independent review panel would evaluate claims based on their merits, and an administrative law judge would be on hand to ensure fairness in the process. It is estimated that this reform would save the state billions of dollars in defensive medicine costs (those unnecessary tests doctors administer out of fear of being sued), as well as court costs. By the way, Florida has one of the most medically litigious counties in the country, Miami-Dade, so almost any system that keeps medical cases out of the courts will benefit them and reduce the malpractice premiums doctors must pay.

The true test will be if a no-fault system will align the incentives of doctors and patients to reduce medical errors and adverse events in the first place. The only way that will happen is if, first, physicians are rewarded for speaking up about adverse events rather than hiding them. Since doctors are reluctant to talk for fear of litigation, a system that for the most part bypasses litigation may encourage freer communication with the patient. And since patients primarily sue to find out information about their case, they would be less inclined to do so anyway.

Second, doctors will most likely improve quality if they are rewarded monetarily. If patient compensation is directly tied to an individual physician's insurance premiums (this means no community rating) or a hospital's cost of self-insuring, the monetary savings would incentivize health care providers to initiate best practices and improve overall quality.

Florida's malpractice solution is a good start.

John C. Goodman is president and founder of the National Center for Policy Analysis, a free-market think tank established in 1983. Goodman’s ideas on health policy can also be found at his own blog, where he provides daily analysis and lively discussion on a wide range of health care topics.

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To: Joe Btfsplk who wrote (22947)3/3/2012 10:42:42 PM
From: greatplains_guy
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The High Price of ‘Free’ Health Care
Mar 12, 2012, Vol. 17, No. 25

Today, in the United States, the federal government does not force insurers to provide free contraception. Yet contraception is as widely available as it is cheap. Most insurance policies cover it. The federal government gives birth control to the poor through Medicaid. The federal government spends an additional $300 million per year to provide it to low-income and uninsured Americans who don’t qualify for Medicaid?—?spending that the staunchest conservatives in Congress supported even when Republicans controlled the presidency, the Senate, and the House. If a middle- or upper-income woman happens to be in one of the small number of plans that don’t cover contraception?—?say, an employee at a college run by Catholic nuns?—?she can buy birth control pills for as little as $9 per month at Target.

Yet by the logic of the Obama campaign and many Democrats in the House and Senate, the current policy amounts to a “ban” on contraception. And the federal government can only right this injustice by forcing private insurers?—?including insurers of religious institutions?—?to provide free contraception, as well as free drugs that can induce abortions early in pregnancy.

“Let’s admit what this debate is really and what Republicans really want to take away from American women. It is contraception,” New York Democrat Chuck Schumer said on the Senate floor. He said Republicans were trying to enact a “contraception ban” that would send the country back to the “19th century.” Not to be outdone, Democratic senator Frank Lautenberg of New Jersey said that Republicans want to take us back to “the Dark Ages .??.??. when women were property that you could easily control, trade even if you wanted to.”

The Obama campaign claimed that Republicans effectively wanted to force women to get a “permission slip” from their employers to “access birth control pills, intrauterine devices, or any other type of contraception.” Obama’s deputy campaign manager wrote in an email to supporters: “If you’re a woman, who do you think should have control over your choice to use contraception: You or your employer?” The New York Times and others in the mainstream press reported Republicans were backing a measure to allow employers to “deny coverage” for contraception, mimicking the Democrats in substance if not in style.

Of course, the bill the Obama campaign and friends were demagoguing wouldn’t have denied anyone access to birth control. The amendment, sponsored in the Senate by Republican Roy Blunt of Missouri and Democrat Ben Nelson of Nebraska, would merely let private employers or insurers opt out of Obama-care’s benefits mandates for moral or religious reasons?—?taking the country all the way back to .??.??. 2012. Americans currently have this right?—?the mandate doesn’t take effect until August for most employers and next year for religious institutions.

The conscience protections in the Blunt-Nelson bill are identical to the protections included in many federal health care laws on the books and even the 1994 Clinton reform that never became law. The bill wouldn’t affect state birth control mandates or federal laws that already require insurers to cover pregnancy, childbirth, mental health, HIV treatments, and other services.

Before a vote on the Blunt-Nelson bill last week, the New York Times reported that “Republicans appeared to be divided.” In fact, just one Republican, liberal Olympia Snowe of Maine, voted against the measure. Three Democrats?—?Nelson of Nebraska, Bob Casey of Pennsylvania, and Joe Manchin of West Virginia?—?voted for it. The measure narrowly failed in the Democratic-controlled Senate.

The question now is whether supporters of religious freedom will keep up the fight. A number of freshmen Republican senators, like Kelly Ayotte of New Hampshire and Scott Brown of Massachusetts, have tackled the issue head-on. Polls taken before and after the fight over the issue show no erosion of support for Brown in the most liberal state in the country.

Yet other Republicans seem skittish about the issue because polls have supposedly shown support for President Obama’s “accommodation” of religious institutions. A Quinnipiac poll, for example, asked voters: “Do you think the federal government should require private employers to offer free birth control coverage as part of their health insurance benefit plans or not?” The results: 47 percent said the government should require free contraception, 48 percent said it should not. In other words, the federal mandate in general split the country down the middle.

The poll then purports to show that the Obama administration’s method of imposing a mandate on religious institutions is popular. Voters were asked:

As you may know, President Obama recently announced an adjustment to the administration’s health-care rule regarding religiously affiliated employers providing birth control coverage to female employees. Women will still be guaranteed coverage for birth control without any out-of-pocket cost, but will have to seek the coverage directly from their insurance companies if their employers object to birth control on religious grounds. Do you approve or disapprove of President Obama’s decision

Worded this way, 54 percent approved, 38 percent disapproved. But the question didn’t poll the policy, it polled Obama’s spin. There was no mention that the federal government would require anyone to do anything. At the very least, a fair question would also present the other side of the argument?—?that Obama’s “adjustment” is an accounting gimmick to which religious institutions still object.

Rasmussen polls show that support for Obama’s policy depends on how you ask the question. Although voters are divided 43 percent to 39 percent on the general policy of requiring contraception coverage, voters oppose mandatory free coverage of the “morning-after pill” 50 percent to 38 percent. No polls have yet been taken on Obama-care’s mandatory free coverage of the “five-day-after pill” called “ella” that can induce abortions during early pregnancy, according to animal testing. And how would voters respond when asked if the federal government should fine religious institutions that refuse to comply with the mandate?

The debate may still be won or lost. The pro-mandate Democrats and their allies in the press have framed it as a fight about “denying access” to birth control. But recall that the “health care reform” bill itself was popular in polls in the spring and summer of 2009. Democrats and the press misled the public about how much it would cost, how many would lose their current insurance, how it would use tax dollars to help pay for abortion-on-demand. Yet opponents of Obama-care managed to get the word out and turn public opinion against the law?—?because it is a bad law and the facts are on their side.

The opponents of Obamacare’s newest mandate requiring free coverage of abortion pills and contraception again have the facts on their side. The mandate provides opponents with the opportunity to again make the case against Obamacare. As one popular sign from the 2009 and 2010 Tea Party rallies warned, paraphrasing P.J. O'Rourke, “If you think health care is expensive now, just wait until it’s free.” The price of “free” health care will be steep in terms of dollars, but even steeper in terms of freedom.

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