I know the title makes no sense, but I figured it might at least make the event seem more interesting than it actually was. I'm not sure what I was expecting, but certainly not what I received; the event was not open to the public, the crowd was completely subdued, and the floor was not open to questions. I'd complain, but they took pre-written questions before the event, and one of the organizers asked congressman Sarbanes the questions during a brief Q&A period. I'd speculate on the person asking only "friendly" questions, but mine was one chosen, so I can't imagine that to be the case.
The set-up for the event was such: John Sarbanes gave a 30 min. introductory talk, going over what they wanted to accomplish with health care reform, what they needed to do yet, and a bit of why it needed to be done. This was followed by representatives from each of the schools here (Pharmacy, Nursing, Law, Social Work, Dentistry, and Medicine) talking about what health care reform means to them, what challenges they see for their profession in the coming years, etc.
All in all, it was non-controversial. Sarbanes stuck to the party line talking points when discussing reform. I was hoping for something YouTube worthy. At least something like, "All those people who oppose this are morons!" Nothing. The only real moments of conflict were drawn from my question and inspired by the dean of the law school, of all people. I asked Sarbanes why litigation reform wasn't on the table (his answer being that studies show that it won't save any costs, though I'm not inclined to believe such and don't think that's sufficient anyhow). When the law school dean was up to speak, he mentioned it again in a, "Yeah, that's not gonna happen," kind of way. However, later when the med school representative spoke, he looked at the rest of the panel and countered with, "Nuts to you guys, we need tort reform." The law school guy spent the rest of the evening shooting daggers with his eyes at the med school speaker. Very exciting, yes?
A couple of things I do want to grab onto, though. First, Sarbanes spoke continually about moving to preventative care as a means of saving money. I have yet to see anybody show this to be the case. In fact, it's part of the "defensive medicine" that doctors complain about practicing now; running extraneous tests to catch something "just in case" is not a money saving procedure.
Second, Sarbanes got an answer about increasing access to health care for the millions of new people who will end up on the public dole because of this, and his answer was incredibly evasive. The fact of the matter is, if you suddenly have 50 million new people with insurance, they're going to start seeing doctors. That means we need a lot more health care workers at all levels, or we're going to have the same, awful staff shortages that Britain's NHS suffers. Exactly how does Congress propose to get these people without the quality of the care suffering?
Third, Sarbanes made a point of saying that the public plan will remain competitive with private insurance because it isn't for-profit, but that it must also stand on its own feet (by law). That is, it can't be taxpayer subsidized by pay for itself. He said with a smirk afterwards that those darn insurance companies are just gonna have to cut executive pay to stay competitive. I could dedicate an entire post to what was wrong with that sentiment, but suffice it to say that nobody in their right mind believes a politician when they say that a program will pay for itself. When has a government program like this ever been within budget? And why on Earth would a politician not opt to "temporarily" infuse tax dollars into the program to keep it afloat once it's running?
He also mentioned that the CBO estimated only 12 million people would be on the public plan after however many years, and I don't recall ever hearing that. You know, because the government has never underestimated the popularity of one of its programs.
Finally, just a bit of rhetoric. In talking about the emphasis in moving to preventative care, Sarbanes stated that it was society's duty to keep people healthy, not just treat them once they're sick. That, as Jonah Goldberg might say, is liberal fascism talking. It is a personal responsibility to take care of oneself. Society has no place there.
(And when Obama appeals to Christians that the Bible says that, "I am my brother's keeper," he's talking out the wrong end of his digestive tract. That never appears in the Bible.)
So, the event wasn't terribly exciting, but it did give me something to blog about. Finally.
4 comments:
No, the phrase "I am my brother's keeper" does not appear in the bible. Of course, Obama never actually claims that it does, he merely professes that it is part of the American experiment includes caring about others. It's adapted from Cain's question to God ("Am I my brother's keeper?") immediately after Cain killed Abel. Cain's a villain in the passage, and the implication is that the answer Cain wants (that he's not responsible for the wellbeing of his brother, even if he did murder him) is the wrong answer. It's an attempt to shirk his responsibility for Abel's death. It's thwarted by omniscience, which makes Cain's attempt at covering up appear cowardly and ill-advised in addition to jealous and irrational. It's not really that far of a stretch to conclude that "I should be responsible for my brother" is something to take away from it, and I'm surprised that that's what you're upset at Obama about. And anyway, what about Jesus' admonitions to help the poor; particularly through the parable of the Sheep and the Goats (Matthew 25:31-46) where he throws "I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.'" out there?
I'm not a biblical scholar, and would never claim to be (and the ones I tend to read tend to be more like Dr. Robert Price, a former Baptist minister and fellow of the Jesus Seminar who supports criticism of the historicity of Jesus) and I'm very strongly against the use of religion in politics, either from the right or the left. But my readings of it seem to support the whole "helping out people who are less fortunate than you is desirable" thing. I'd just as soon leave the Bible and any other religious texts out of it.
As for the actual post, I'd have to see some data on how much money preventative care would save. Sure, the tests are extraneous if there's nothing for them to find (and that's usually going to be the case), but how much would early diagnosis save for someone in the early stages of, say, liver cancer?
I'm not at all sure how the health care industry would cope with having 50 million more insured people suddenly going to doctors, but it's not as though they're just not going as it is. They are, they're just going to emergency rooms and the taxpayers are helping pay for them as it is. Insuring more people would certainly ease the burden on emergency room staff (which would be useful to people that actually need the emergency room for emergency purposes and not just because they can't afford to go where they should be going), and I'm not quite sure what effect it would have on the taxpayer. I don't have the data to make that conclusion. I'm not sure the solution is "just let the people too poor to afford insurance die, because it'd be a burden to treat them."
I'm not really sure where to come down on the healthcare debate. Obviously, insurance reform is mandatory (the stories, acknowledged by the heads of the major insurance companies, of people paying their premiums while they're healthy, then getting kicked off their insurance once they're sick is nothing more than theft and is beyond defense), and I'm not sure what system would be the best for the United States.
Hey Ryan, glad to see someone's still coming by. I should probably devote a separate post to the religious discussion, lest it obscure the actual content of the post itself. Suffice it to say that conservatives consider the Biblical injunction to care for the poor to be a charge for Christians, not the government; the money forcefully extracted by taxation does not satisfy this responsibility.
The entire idea of "preventative" medicine is predicated upon more care prior to sickness. This necessitates spending more money. For example, let's say that only 1% of people get some form of cancer, but the government "encourages" that people be tested for it yearly. Does the higher rate of early detection pay for the increased testing being done? I'm doubtful, but I don't have numbers to back that up.
Still, the entire idea is predicated upon "incentivizing" doctors to keep patients healthy in the first place. Which would be all well and good, except that much "preventative" care is dependent upon patients following their doctors' instructions. Diabetes (and subsequent amputations) are a favorite instruction, but should we punish doctors because their patients didn't stick to their diets?
Either way, personnel shortages are a big worry. Britain's NHS suffers from perpetual staff shortages; Illinois's AllKids program had trouble getting off the ground because few doctors in the state would accept the patients (though I don't know how it's done in the intervening years).
The bottom line for me in rejecting all of this is cost: It's going to have a huge price tag on it, and we're already in a recession. High taxes will cripple any recovery, and much of the "restructuring" that Obama plans for the insurance industry could cause it to collapse. Philanthropic motivations are all well and good, but not entirely helpful if they carry such price tags.
Two posts, because apparently I wrote a ton and blogger won't let me leave a comment longer than 4096 characters.
Suffice it to say that conservatives consider the Biblical injunction to care for the poor to be a charge for Christians, not the government;
That fits my desire to keep politics and religion separate, and Obama was clearly trying to appeal to Christians to help his political goals, as politicians have been doing for quite a while now, and which I don't defend. I wouldn't deny that, I was just attempting to rationalize the words he was using in a biblical context. Of course, I'd have much less of a problem with the Religious Right if the policy of acknowledging that the Bible should apply to Christians rather than having the government step in to enforce what the Bible says to the people who believe in it. State Constitutional requirements to profess belief in a higher power to hold elected office, attempts to water down presentations of evolution in classrooms in order to prop up creationist curricula and support for government oversight of who marries whom, who sleeps with whom and what citizens put in their bodies all directly contradict the concept that conservatives wish to apply religious texts in their own lives without the government forcing them to or forcing people of other religions or no religion to follow Biblical injunctions.
The entire idea of "preventative" medicine is predicated upon more care prior to sickness. This necessitates spending more money. For example, let's say that only 1% of people get some form of cancer, but the government "encourages" that people be tested for it yearly. Does the higher rate of early detection pay for the increased testing being done? I'm doubtful, but I don't have numbers to back that up.
Attempting to discuss whether preventative care actually saves money in the abstract is impossible. Some preventative measures do help save money (by either early diagnosis or by actually preventing the onset of disease, as with diagnosis) and improve health, while some improve health while not saving money, and some actually worsen health while increasing cost. The New England Journal of Medicine did an analysis of the cost effectiveness of preventative care treatments (expressed as dollars per quality-adjusted life year) which speaks to this, that whether a preventative measure is "worth it" depends largely on which preventative measure you're talking about. Obviously, any healthcare plan would have to take this into account, as insurance companies already do. I don't think anyone has proposed a plan where every preventative care measure is demanded and to pretend that that's the case doesn't capture the reality of the situation.
Either way, personnel shortages are a big worry. Britain's NHS suffers from perpetual staff shortages; Illinois's AllKids program had trouble getting off the ground because few doctors in the state would accept the patients (though I don't know how it's done in the intervening years).
I agree, and obviously there's got to be some workaround for this. However, the British model is not the only model. The Germans have something much different than either of our systems, and the population is supportive of the system. The same is true of Japan. Here, we've got a mishmash of a bunch of different systems, and that's not necessarily a bad thing, but it's also not a dichotomy. It also ignores the fact that Emergency Rooms are already drastically understaffed and suffer from overcrowding precisely because it's the only recourse for the uninsured. It's obvious that any healthcare option isn't going to be as radical as the Canadian or British system, but I'm really not sure the solution to potentially longer waits for treatment is "just let those too poor to afford coverage die."
Part 2:
The bottom line for me in rejecting all of this is cost: It's going to have a huge price tag on it, and we're already in a recession.
So you were down with nearly $700 billion in Iraq and $200 billion in Afghanistan (which will likely cost more as troops were relocated to Iraq before Afghanistan was secured), neither included in the national budget, but now you're worried about cost? It's not an unreasonable concern, and though the economy is improving lately, I'm not sure a tax hike in a recession is the best idea, and I'm not convinced by the assurances that it's not going to have to happen. I think we should be skeptical of where our money goes. But where was the skepticism during the previous administration's spending spree?
much of the "restructuring" that Obama plans for the insurance industry could cause it to collapse.
I wasn't aware that there was much "restructuring" in the current plan. Certainly there are regulations, which I'm fine with in the same way that I'm fine with the FDA existing or anything else that acts as a validation to consumers that they're not going to get screwed, and if there were a public option, it's a valid concern, but I'd like to see some more data before accepting the claim that the insurance industry would collapse if the Democrats pass their version of healthcare reform.
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