Wednesday, August 19, 2009

Healthcare Rationing: Real Scary - Newt Gingrich

http://www.healthtransformation.net/cs/opeds_news?pressrelease.id=2880

August 16, 2009

Concerns about government bureaucracies gaining oversight of your treatment are not misplaced. We need reforms, but the answer is not central planning.

By Newt Gingrich

When Sarah Palin said that the emerging healthcare reform legislation would lead to "death panels" and government rationing of care, her language was explosive, but her premise about rationing was not.

The most critical test of any reform proposal is whether it will empower individuals or impose on them. It is a fact that the leading bills in Congress would increase the power of government and decrease individual freedom. You cannot spend an additional $1 trillion of taxpayer money and reduce the role of government. You will get new bureaucracies, more regulation, more complexity. That means you will have less control of your healthcare.

Disagree? Just read the versions of healthcare legislation:H.R.3200 in the House. One key proposal is to mandate an "essential benefit package" for every private insurance policy sold in the United States. Currently, individuals and employers usually make these coverage decisions. This legislation creates a new federal Health Benefits Advisory Committee that would decide instead. For example, if you are a single male with no children, the legislation still requires you to have maternity benefits and well-baby and well-child care coverage. You don't want or don't need that coverage? Sorry, you have to pay for it anyway.

Other planned agencies would give the federal government unprecedented and unaccountable control over your healthcare. The so-called Health Choices Administration and the National Health Insurance Exchange would set various standards for all health insurance policies. The president is also pushing for another new agency called the Independent Medicare Advisory Council. Described as a cost-control initiative,it would be made up of five government appointees who would, by determining Medicare reimbursement amounts, in essence decide what would be covered and what would not. The fear of government rationing is based on the premise that once government has such power, especially the ability to control what is covered by your private insurance policy, it also has the power to deny and restrict.

Those defending the House legislation claim rationing is not in any of its versions, and though that is technically true -- no one wants rationing -- the unprecedented power this legislation would grant to virtually unaccountable government agencies is all but certain to lead to rationing.
Consider Medicare, which is projected to go broke within the decade. As the baby-boom generation ages, it will put only more stress on the system. With more than 25% of all Medicare costs generated in the last two months of life, government already has the motive to ration care to the elderly. If the House legislation were to become law, these new government bureaucracies would then also potentially have the power. Are we supposed to trust that they won't use it?

If such rationing occurs, rules will be needed to determine whether to spend federal healthcare dollars on a given individual. What might those rules look like? Dr. Ezekiel Emanuel is a key healthcare advisor to President Obama and the brother of White House Chief of Staff Rahm Emanuel. He co-wrote an academic article(09)60137- in January exploring the ethical challenges of valuing an individual's life in the context of allocating medical resources that are very scarce, such as organs or vaccines.

As an example, he and his coauthors proposed a system of valuation that could take into account that "[a] young person with a poor prognosis has had few life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern that disproportionately large amounts of resources will be directed to young people with poor prognoses."

In a 1996 article in another journal, Dr. Emanuel similarly hypothesized that "services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia."

Dr. Emanuel contends that he was exploring what rules might be used to ration care, not specifically prescribing policy. But isn't that the point? What we see at town hall meetings are Americans who legitimately believe it would be fundamentally unjust for government panels to make these kind of ethical decisions instead of individuals, loved ones and doctors.

To be clear, the healthcare system is in need of reform, particularly health insurance. But the answer is not central planning. The answer is more market competition -- giving consumers more choices, more information and more control.

Here is one example. There are more than 1,300 health insurance companies in this country, but currently, consumers can buy only a product licensed in each individual state. Creating a nationwide health insurance market where any individual or group can shop for less expensive coverage from another state would provide more choices, forcing private plans to create better products, improve services and lower prices.

We must also equip individuals with information on healthcare cost and quality. Releasing the Medicare-claims history of doctors and hospitals (with patients' personal information removed) would give Americans more knowledge to choose the most efficient institutions, practitioners and the most effective treatments. Inexplicably, this taxpayer-funded data remain locked away.

Of course, some Americans also need financial resources to pay for their healthcare choices. Tax credits are one way to help consumers purchase private healthcare coverage, or we could allow individuals to deduct the cost of insurance they purchase, just as employers do now. These are just some solutions to create competition to drive down costs while increasing quality.

There is no doubt that we badly need to improve our healthcare system. I welcome the comprehensive debate now taking place across the country on how to accomplish this goal. But reform must empower individuals, not government.

Former Speaker of the House Newt Gingrich is founder of the Center for Health Transformation.

Copyright © 2009, The Los Angeles Times

Monday, August 17, 2009

Overhauling health-care system tops agenda at annual meeting of Canada's doctors

http://www.google.com/hostednews/canadianpress/article/ALeqM5jbjzPEY0Y3bvRD335rGu_Z3KXoQw

By Jennifer Graham (CP) – 8/16/09

SASKATOON — The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.

Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.

"We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize," Doing said in an interview with The Canadian Press.

"We know that there must be change," she said. "We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands."

The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.

His thoughts on the issue are already clear. Ouellet has been saying since his return that "a health-care revolution has passed us by," that it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared."

In other words, Ouellet believes there could be a role for private health-care delivery within the public system.

He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump-sum budget. This "activity-based funding" would be an incentive to provide more efficient care, he has said.

Doig says she doesn't know what a proposed "blueprint" toward patient-centred care might look like when the meeting wraps up Wednesday. She'd like to emerge with clear directions about where the association should focus efforts to direct change over the next few years. She also wants to see short-term, medium-term and long-term goals laid out.

"A short-term achievable goal would be to accelerate the process of getting electronic medical records into physicians' offices," she said. "That's one I think ought to be a priority and ought to be achievable."

A long-term goal would be getting health systems "talking to each other," so information can be quickly shared to help patients.

Doig, who has had a full-time family practice in Saskatoon for 30 years, acknowledges that when physicians have talked about changing the health-care system in the past, they've been accused of wanting an American-style structure. She insists that's not the case.

"It's not about choosing between an American system or a Canadian system," said Doig. "The whole thing is about looking at what other people do."

"That's called looking at the evidence, looking at how care is delivered and how care is paid for all around us (and) then saying 'Well, OK, that's good information. How do we make all of that work in the Canadian context? What do the Canadian people want?' "

Doig says there are some "very good things" about Canada's health-care system, but she points out that many people have stories about times when things didn't go well for them or their family.

"(Canadians) have to understand that the system that we have right now - if it keeps on going without change - is not sustainable," said Doig.

"They have to look at the evidence that's being presented and will be presented at (the meeting) and realize what Canada's doctors are trying to tell you, that you can get better care than what you're getting and we all have to participate in the discussion around how do we do that and of course how do we pay for it."

Copyright © 2009 The Canadian Press. All rights reserved.

Saturday, August 15, 2009

Top 10 Reasons Obamacare Is Wrong for America

  1. Millions Will Lose Their Current Insurance. Period. End of Story: President Obama wants Americans to believe they can keep their insurance if they like, but research from the government, private research firms, and think tanks show this is not the case. Proposed economic incentives, plus a government-run health plan like the one proposed in the House bill, would cause 88.1 million people to see their current employer-sponsored health plan disappear.
  2. Your Health Care Coverage Will Probably Change Anyway: Even if you kept your private insurance, eventually most remaining plans--whether employer plans or individual plans--would have to conform to new federal benefit standards. Moreover, the necessary plan "upgrades" will undoubtedly cost you more in premiums.
  3. The Umpire Is Also the First Baseman: The main argument for a "public option" is that it would increase competition. However, if the federal government creates a health care plan that it controls and also sets the rules for the private plans, there is little doubt that Washington would put its private sector "competitors" out of business sooner or later.
  4. The Fed Picks Your Treatment: President Obama said: "They're going to have to give up paying for things that don't make them healthier. ... If there's a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half for the thing that's going to make you well." Does that sound like a government that will stay out of your health care decisions?
  5. Individual Mandate Means Less Liberty and More Taxes: Although he once opposed the idea, President Obama is now open to the imposition of an individual mandate that would require all Americans to have federally approved health insurance. This unprecedented federal directive not only takes away your individual freedom but could cost you as well. Lawmakers are considering a penalty or tax for those who don't buy government-approved health plans.
  6. Higher Taxes Than Europe Hurt Small Businesses: A proposed surtax on the wealthy will actually hit hundreds of thousands of small business ownerswho are dealing with a recession. If it is enacted, America's top earners and job creators will carry a larger overall tax burden than France, Italy, Germany, Japan, etc., with a total average tax rate greater than 52%. Is that the right recipe for jobs and wage growth?
  7. Who Makes Medical Decisions? What is the right medical treatment and should bureaucrats determine what Americans can or cannot have? While the House and Senate language is vague, amendments offered in House and Senate committees to block government rationing of care were routinely defeated. Cost or a federal health board could be the deciding factors. President Obama himself admitted this when he said, "Maybe you're better off not having the surgery, but taking the painkiller," when asked about an elderly woman who needed a pacemaker.
  8. Taxpayer-Funded Abortions? Nineteen Democrats recently asked the President to not sign any bill that doesn't explicitly exclude "abortion from the scope of any government-defined or subsidized health insurance plan" or any bill that allows a federal health board to "recommend abortion services be included under covered benefits or as part of a benefits package." Currently, these provisions do not exist.
  9. It's Not Paid For: The CBO says the current House plan would increase the deficit by $239 billion over 10 years. And that number will likely continue to rise over the long term. Similar entitlement bills in the past, including Medicare, have scored much lower than their actual eventual cost.
  10. Rushing It, Not Reading It: We've been down this road before--with the failed stimulus package. Back then, we also heard that we were in a crisis and that we needed to pass a 1,000-plus-page bill in a few hours--without reading it--or we would have 8% unemployment. Well, we know what happened. Now, one Congressman has even said it's pointless to read one of the reform bills without two days and two lawyers to make sense of it. Deception is the only reason to rush through a bill nobody truly understands.

For more information, please visit: http://FixHealthCarePolicy.com

President Obama's 'Wild Misrepresentations' on Health Care

President Obama hosted a townhall meeting yesterday afternoon that seemed more scripted than some of the soap operas that his broadcast was competing with. Not surprisingly, the meeting was carefully choreographed--so much so that the President couldn't find a single person to disagree with him. Apparently his was the only townhall in the entire country where there wasn't at least one voter opposed to a government takeover of health care. Unlike the millions of concerned citizens packed into local gymnasiums and city halls, this event was replete with a select group of White House cheerleaders. Even the little girl, who famously asked why the other side is so "mean," turned out to be the child of an Obama donor, who is important enough to have already met the First Family and Vice President Joe Biden at a previous fundraiser. Coincidence? As Michelle Malkin pointed out, there are no coincidences in this administration. What was more amazing than all this premeditation is how the President accused groups like FRC of engaging in "wild misrepresentations" while engaging in a series of incredible distortions himself.

The whoppers he told ranged from fudging the plan's list of supporters to the details of the plan itself. At one point he told the crowd, "We have the AARP on board because they know this is a good deal for our seniors." That was news to the AARP, who disputed the endorsement immediately after the townhall concluded. Tom Nelson, AARP's chief operating officer, told reporters, "Indications that we have endorsed any of the major health care reform bills... are inaccurate." The President also claimed, "Under the reform we're proposing, if you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan." But an independent study commissioned by the Heritage Foundation actually found that 88.1 million people would be shifted out of their current employer-based plan.

As part of his pitch, the President also tried to compare his health care overhaul to the competition between FedEx and the U.S. Post Office. He said, "If you think about it, UPS and FedEx are doing just fine, right? No, they are. It's the Post Office that's always having problems." It's a false comparison for several reasons, but mainly because the U.S. Postal System is heavily regulated and, as a result, it's weighed down by federal mandates - just as the President's health plan would place burdensome new regulations on private insurance companies. That's why his statement is so revealing about why a government takeover of health care is not the solution. The American people are outraged because they don't want health care delivered with the empathy of the IRS, the efficiency of FEMA or the mismanagement of the Post Office. The Post Office lost $ 2.8 billion last year while giving a $ 135,000 "performance bonus" to its top executive. And because the USPS is federally run and funded monopoly, it is unaccountable for its perpetual fiscal mess--just like Medicare. That's not the kind of change the American people are hoping for.

Of course, the President's biggest misrepresentation was his insistence that he doesn't back a single-payer system. "I have not said that I was a single-payer supporter," he told yesterday's audience. Maybe he hasn't said it as President, but last August, candidate Obama told an Albuquerque townhall, "If I were designing a system from scratch, I would probably go ahead with a single-payer system." The bottom line, Mr. President, is that if you portray yourself as an honest man, it helps if you keep your facts straight.

Tuesday, August 04, 2009

THE ONE WORD TO DESCRIBE OBAMACARE

Written by Dr. Dave Janda
Thursday, 23 July 2009

As a physician who has authored books on preventative health care, I was given the opportunity to be the keynote speaker at a Congressional Dinner at The Capitol Building in Washington last Friday (7/17/09).

The presentation was entitled Health Care Reform, The Power & Profit of Prevention, and I was gratified that it was well received.

In preparation for the presentation, I read the latest version of "reform" as authored by The Obama Administration and supported by Speaker Pelosi and Senator Reid. Here is the link to the 1,018 page document:

http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf

Let me summarize just a few salient points of the above plan. First, however, it should be clear that the same warning notice must be placed on The ObamaCare Plan as on a pack of cigarettes: Consuming this product will be hazardous to your health.

The underlying method of cutting costs throughout the plan is based on rationing and denying care. There is no focus on preventing health care need whatever. The plan's method is the most inhumane and unethical approach to cutting costs I can imagine as a physician.

The rationing of care is implemented through The National Health Care Board, according to the plan. This illustrious Board "will approve or reject treatment for patients based on the cost per treatment divided by the number of years the patient will benefit from the treatment."

Translation.....if you are over 65 or have been recently diagnosed as having an advanced form of cardiac disease or aggressive cancer.....dream on if you think you will get treated.....pick out your coffin.

Oh, you say this could never happen? Sorry.... this is the same model they use in Britain.

The plan mandates that there will be little or no advanced treatments to be available in the future. It creates The Federal Coordinating Council For Comparative Effectiveness Research, the purpose of which is "to slow the development of new medications and technologies in order to reduce costs." Yes, this is to be the law.

The plan also outlines that doctors and hospitals will be overseen and reviewed by The National Coordinator For Health Information and Technology.

This " coordinator" will "monitor treatments being delivered to make sure doctors and hospitals are strictly following government guidelines that are deemed appropriate." It goes on to say....."Doctors and hospitals not adhering to guidelines will face penalties."

According to those in Congress, penalties could include large six figure financial fines and possible imprisonment.

So according to The ObamaCare Plan....if your doctor saves your life you might have to go to the prison to see your doctor for follow -up appointments. I believe this is the same model Stalin used in the former Soviet Union.
changes
Section 102 has the Orwellian title, "Protecting the Choice to Keep Current Coverage." What this section really mandates is that it is illegal to keep your private insurance if your status - e.g., if you lose or change your job, retire from your job and become a senior, graduate from college and get your first job. Yes, illegal.
When Mr. Obama hosted a conference call with bloggers urging them to pressure Congress to pass his health plan as soon as possible, a blogger from Maine referenced an Investors Business Daily article that claimed Section 102 of the House health legislation would outlaw private insurance.

He asked: "Is this true? Will people be able to keep their insurance and will insurers be able to write new policies even though H.R. 3200 is passed?" Mr. Obama replied: "You know, I have to say that I am not familiar with the provision you are talking about."

Then there is Section 1233 of The ObamaCare Plan, devoted to "Advanced Care Planning." After each American turns 65 years of age they have to go to a mandated counseling program that is designed to end life sooner.

This session is to occur every 5 years unless the person has developed a chronic illness then it must be done every year. The topics in this session will include, "how to decline hydration, nutrition and how to initiate hospice care." It is no wonder The Obama Administration does not like my emphasis on Prevention. For Mr. Obama, prevention is the "enemy" as people would live longer.

I rest my case. The ObamaCare Plan is hazardous to the health of every American.

After I finished my Capitol Hill presentation, I was asked by a Congressman in the question-answer session: "I'll be doing a number of network interviews on the Obama Health Care Plan. If I am asked what is the one word to describe the plan what should I answer."

The answer is simple, honest, direct, analytical, sad but truthful. I told him that one word is FASCIST.

Then I added, "I hope you'll have the courage to use that word, Congressman. No other word is more appropriate."

Dr. Dave Janda, MD, is an orthopedic surgeon, and a world-recognized expert on the prevention of sports injuries, particularly in children. His website is www.noinjury.com .