Monday, August 31, 2009

Health Care, Cardiologists, Medicare, Death Panels, and AARP Betrayal: The Myth of Federal "Cost Control"

It is actually laugh-out-loud funny. At the same time the Obama Administration and the mainstream media are saying that it represents "scare tactics" to worry about Federal control of health care, the Obama Administration has announced new, proposed REDUCTIONS in Medicare reimbursement to cardiologists and oncologists. The Obama Administration is proposing to "transfer" the money saved by cutting heart care and cancer care to the elderly to the more "cost effective" "preventive care" of family physicians. This, of course, is what central planning bureaucrats and politicians always do: They choose the WINNERS and the LOSERS by the regulations they impose. Cardiologists are upset because their Medicare payments will be reduced as much as 40%--a nice little discouragement to heart care for the elderly.


Does this represent a central planning decision that it is better to let some of the "sick" (using more than their "fair" share of medical resources) elderly die, while concentrating more on the "healthy elderly" (not using so much of our health care resources)? Of course this represents such a central planning decision--a decision made by Federal bureaucrats rather than doctors and patients. No, the Feral bureaucrats will not determine that specific people will die if/when the Federal government controls health care decisions in this country. When you are unable to find a competent cardiologist to treat your ailing heart, or a competent oncologists to prolong your life--as oncologists did with Senator Kennedy--it will not be a matter of "pulling the plug" on you personally. You will be merely part of a number of anonymous elderly who die because they do not have access to the heart care and cancer care they need. This will happen not only because doctors refuse to treat you (which may happen), but more because there will no longer be any competent cardiologists or oncologists to provide you specialized care.


What are the major causes of death for the elderly (other than old age)? Right. Heart disease and cancer. But that care is expensive. What happens when you make it harder for cardiologists and oncologists to get paid for life saving treatment of heart disease and cancer. Right again. PEOPLE DIE. They don't necessarily die because they are refused treatment (although that may end up happening). They die because treatment just becomes UNAVAILABLE. The good cardiologists and oncologists treat someone like Ted Kennedy, who can pay them what their services are "worth" on the open market, or even go to a foreign country. Or they retire early. Or they never go into cardiology or oncology at all, and perhaps not into medicine (as the Federal Government puts more and more pressure on doctors to keep them from making the kind of money their skills and training would justify.


The elderly generally understand this. My 888 year old mother does. Medicare quit paying fro one of her breathing medications, at least at the former reimbursement rate. That was a medication previously being provided to her by Apria (or something like that)--her oxygen provider. Yes, she is on constant (24 hour) oxygen--using up a lot of health resources. She was also a lifelong smoker (HORRORS!!! Kill her off now). Now my mother has 5 sons, including a pharmacist son. She can get medication she really wants--on way or another, at least for now. There may come a time when only the very rich, like Ted Kennedy, can avoid the long arm of Federal control. That is what at stake in this debate over health care "overhaul" to expand Federal control over all health care. In the end, Federal bureaucrats trying to "control costs" are going to try to kill off people like my mother--nothing personal, just the result of n8umber crunching and lack of access to care.


The elderly understand that this is a real risk--not a fantasy of Sarah Palin. They understand that, like my mother, they may stop breathing some night because the drug that BEST keeps their lungs operating. is deemed "too expensive", and not "significantly" more effective than a cheaper drug. The question is whether we want Federal bureaucrats controlling most health care decisions in this country.


You say President Obama promised this will not happen? You poor, deluded soul. This is not only a question of whether you can trust President Obama (valid as that question is). President Obama will only be President 8 years, at most. The Federal bureaucracy is there FOREVER (at least until the final collapse because the government has grown so massive it collapses of its own weight--or, rather, we collapse because of its weight upon our shoulders). Why is it better to have a FEW Federal bureaucrats making health care decisions, instead of a variety of insurance companies, state regulators, etc.? What do Federal health care "reform" proponents mean by "cost control", anyway, if they do not mean exactly what has just happened with regard to Medicare reimbursement for cardiologists and oncologists?


That is the crux of things, and the utter failure of the mainstream media here (not to mention Republican politicians and supposed "responsible" Democrat politicians, who keep flirting with the idea of a "compromise" imposing Federal control in as deceptive a way as possible). "HOW" is the question that is not asked. The mainstream media makes much of what ObamaCare will NOT do. Yet, the burden is on the Obama Administration, and proponents of health care "reform", to explain what it WILL do--not in the form of rosy conclusions as to thee fantasy "benefits" of Federal action, but in terms of the MECHANISM by which "cost control" is going to operate.


For example, the House bill evidently sets up some 45 new Federal agencies. However, many it is, what will these Federal agencies have the power to DO? For that matter, what new powers will the old Federal agencies be given. HOW is it envisioned that they will accomplish "cost control", and more "efficient" health care and health insurance? Are they not going to make the kind of decision just announced by Medicare--telling doctors and patients what treatments will be "reimbursed", and how much will be paid health care providers? And how does that differ from Federal "control" of health care, whether there is a "government option" or not? How else can you even attempt "cost control"? Explain please (as if you proponents of health care "reform" can explain, when we know you can't). Obama implies that the Federal government can just wave a magic wand and accomplish "cost control". The reality is that the key word here is CONTROL. The only means contemplated by Obama is FEDERAL CONTROL--the only means Obama proposes to use to "control costs".


Is there anything else? Well, we could stop MERGERS of health care companies (large ones). We could try to keep the number of decision makers as LARGE as possible, instead of trying to make that number as SMALL as possible. We could encourage more admissions to medical school (instead of severely restricting the number of students admitted to limit the number of doctors). In other words, we could encourage COMPETITION, and the free market--probably in a number of ways. What a concept!!! Notice, however, that this is NOT "central planning". It promises no "magic bullet"--no CONTROL of the process by a few people promising to "solve" all of our problems. There is no "comprehensive reform". In fact, we should encourage the STATES to try 50 different approaches. The idea here is DIVERSITY, and the spending only of money we have (which the states are ordinarily required to do--not being able to print money or get away with borrowing too much of it). Yes, this approach totally rejects the idea that the Federal Government can "solve" all of our problems. So? Just where did you get the impression that such idea ever made any sense? Experience?...............................Have you stopped laughing yet? I paused to let you get it out of your system.


Yes, we are seemingly stuck with Medicare, and Medicaid (another area where the Federal Government is distorting medical care by decisions on what care will be provided at what allowed price). That is what makes the actions of AARP such a BETRAYAL of senior citizens. The AARP administration has been BOUGHT OFF in this health care "debate", as have the "evil drug companies", in an effort to advance their own power and wealth. "Seniors be damned" is their attitude. The AARP considers seniors as simply a power base, and source of funds, for the Big Government people who run AARP.


As illustrated by this attempt to restrict cardiac care, and cancer care, for seniors, Medicare has SIGNIFICANT problems. It is going to hurt the elderly badly for the Federal Government to try to control the entire health care system, when the government needs to be trying to save Medicare (and Medicaid). If the Federal Government has any good ideas on "cost control", it needs to use them to save Medicare--not to finance a further expansion of Federal control.


Has the American Medical Association (AMA) also sold out? Of course it has. Why any doctors support the AMA is beyond me. I think it is going the way of the mainstream media--becoming only a leftist interest group. Yes, AARP is a more exact analogy, but the "leaders" of all of these organizations seem to eventually decide to promote their own power and prestige, and their group as part of the "establishment" power structure, rather than promoting the actual interest of their members.


P.S. I saw a representative of some cardiology association on TV this morning, complaining about this Medicare/Obama decision to cut reimbursement to cardiologists> Problem: The person said that "we have supported health care reform, but this is the wrong kind of action.". It makes me absolutely sick how many "establishment" people say something like that. I have ev3en heard Rush Limbaugh say it. I will translate for the cardiology group: "We favor Federal control so long as they are controlling insurance companies and other bad people, but not when they are controlling us good people in a way we don't want." I have no sympathy for the point of view that central planning (tort reform on national level?) is okay so long as it does not affect ME. That is the dirty little secret of Federal CONTROL. It puts decisions affecting your life in the hands of Federal bureaucrats, and eventually those decisions will hurt YOU (as central planning always does). Nope. We do NOT "need" Federal "overhaul" (control) of our health care system. We can't afford it now anyway, but even if we could afford it, it is a bad idea. You could try "small"changes, like amending HIPA (Health Insurance Portability Act). A relatively simple amendment to HIPA would prevent insurance companies from raising premiums for pre-existing conditions--presumably with some sort of provision to prevent people from waiting to be insured until they need it. Notice, however, that such a law (which I do NOT support, on a Federal level, although a simple law like that would be much better than some monstrosity of Federal control/"overhaul" of hour entire system)--such a law would INCREASE the cost of insurance for MOST people, although it would decrease the cost for those who have a pre-existing illness/condition. That is why I favor that sort of thing be done on a state level, where things can be tried and more easily changed. My brother worries about employers being faced with var tying state laws (did you realize "evil" WAL-MART is "on board" for Federal control of health care, obviously believing it will allow Wal-Mart to shift costs to American taxpayers). "TOUGH" is my reaction to employers faced with differing state health care policies. You either believe in federalism (few really do) or you don't. I have confidence that Wal-Mart can handle it.

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