From our friends at the South Carolina Medical Association

Dear Colleague, [This was sent to the members of the SCMA – my comments are in italics below.]

The momentum that has been building in support of a nationalized health care system appears to be overwhelming. With health care overhaul bills on the fast-track in Congress, and with a new and powerful administration determined to pass legislation this year, the deck is stacked against us. We’ve been told to sit in the corner and watch while the “experts” figure out how to fix health care. The problem is that the “experts” who are fixing health care are the same people who have run Medicare into insolvency and created a Medicaid system that is inefficient and ineffective.

The federal government is kicking us down the road toward indentured servitude. Envision a world where each decision you make for every patient has to be approved through the laborious channels of government bureaucracy. Imagine the federal government dictating to you which patients yo can and cannot see and which treatments you can and cannot provide—not just for Medicare patients but for all of your patients. Consider what it will be like to be reimbursed for all of your patients at levels significantly less than current Medicare.

Physicians have been offered a seat at the table so long as we sit still with our hands folded in our laps and keep our mouths shut. Dutiful compliance and inaction are no longer options. The muzzle that the Feds placed on us must be removed and the decibel level of our voices must be raised so that we are unmistakably heard. We’re not suggesting a strike, but anything short of that is the kind of bold and thunderous statement we need to be making right now.

The leadership of the South Carolina Medical Association senses the anger and the building resentment and confusion that physicians are currently experiencing. Our commitment to channeling these strong feelings into action is strong and will not lessen. W will not stand silent and watch while the federal government destroys our health care system. In the next few weeks, we will be laying out a course of action to ensure that our voice is heard. Be ready to act quickly, speak loudly, and fight for your career and the health care freedoms your patients deserve.

[Signed by the President and Chair of the Board of the SCMA]

Wow. They must be practicing in paradise down there in South Carolina. No problems, everybody’s insured, getting great preventive and chronic care, nobody goes bankrupt from health care expenses, etc. Maybe we all should move there. Because, you know, in the rest of the country we have ridiculous bureaucracies, rules, and non-physicians telling us what we can do and who we can see and what we can charge already, only they are our private health insurance companies.

But here is the money quote, “Consider what it will be like to be reimbursed for all of your patients at levels significantly less than current Medicare. ” And that’ really what it boils down to for so many, doesn’t it? And besides, the answer to this question is that, if I don’t have to hire a team of staff to fight with PRIVATE insurers to get reimbursed, to get prior approval, to jump through all of their hoops, maybe that reimbursement would result in a higher net reimbursement. And at least Medicare doesn’t tell my patients whether they can see a physician because he’s not on the right panel.

SCMA, what is the solution? Or aren’t there any problems with the health care system in South Carolina.

Maybe they’re still all practicing in Mayberry in the 1950’s, but for the rest of us, we need to fix this broken system!

I ranted further over at dailykos…

Wow. This is not about healthcare reform with these people. These are like the Japanese soldiers found on islands 20 years after WW II, still fighting against the Yankees. They are opposing a Soviet medical gulag, entirely a figment of their imaginations and deep paranoia. Lively debate, eh?

But, to the letter’s substance, and frankly, its’ ignorance.

Nationalized, or singe payer, if that’s what they mean, is pretty much off the table according to the guys in charge of the process like Baucus. It would be nice to have the momentum for that, but although there are vocal supporters at the grass roots level, the powers that be will not hear of it. But sadly, I doubt they even know what they mean when they say “nationalized.” I am sure they have some conceptual bogey man system hybrid of the UK, Canada, and the old Soviet Union in their heads, but I am equally certain they have not spent more than 10 minutes actually learning any comparative health care, even bothered to investigate the systems in Germany, France, Australia and elsewhere.

“The deck is stacked against us.” Is that against patients, physicians, insurance companies, who? Who is the deck stacked against?

“We’ve been told to sit in the corner…” Really? The message I’ve heard from Congress and the White House is that they value and want physician input. Maybe they don’t want bat-shit crazy input, but they want input.

“The same people who have run Medicare into insolvency…” Um, that would fall quite largely on the shoulders of physicians. We have abdicated our role in shaping health care policy and controlling spending and reducing unwarranted and dangereous practice variation and having realistic end-of-life discussions with our patients and so on. We have also not called BS on the private insurers who steal health care dollars in the name of private enterprise and we have taken the money of Pharma for ou meetings and lunches and pretended they were spending all that money on R & D and not on recruiting cheerleaders. Literally recruiting cheerleaders.
But I’m with them on the Medicaid thing.

“The federal government is kicking us down the road toward indentured servitude.” Seriously? Don’t you guys have private health insurance companies in South Carolina? But really, this letter is not about health care, this is a stale ideology in its last throes.

“Physicians have been offered a seat at the table so long as we sit still with our hands folded in our laps and keep our mouths shut. “
Again, one has to have reasonable views to expect to be listened to seriously Foaming at the mouth like Zell Miller and Sean Hannity does not invite reasoned discussion. But listen, all of the physician supporters of single payer have much more to gripe about than the SCMA. At least organized medicine is participating in discussions, while PNHP has to have a major grass roots insurrection just to get invited to the White House photo-op. If anybody has the right to gripe about exclusion, it’s the progressives, not the conservatives.

“The leadership of the South Carolina Medical Association senses the anger and the building resentment and confusion that physicians are currently experiencing.” I expect this is true. SC represents a far more conservative population than most states (it’s in the top 10 most red states), and so their phsyicains likely are more conservative as well. So, fine, make your case, but we will not sit quietly by and let you screw up the best chance for health care reform we’ve had in this country’s history.

The final line about fighting “for your career and the health care freedoms your patients deserve.” Again, maybe I’m practicing in a dark dystopic bit of America, but around here, that ship has sailed. Our patients, even the insured ones, have little choice in doctors or hospitals. They only go to whom and where their plan allows. No “freedom” there. And our careers? Whose careers? Your primary care physicians careers? Really? I’ll let my colleagues decide who you’re really looking out for. My bet is that you’re looking out for your failed ideology, not for physicians or patients.

McCarthyism and health reform – Joe Paduta

Managed Care Matters:

“Ya gotta do your research.

“That’s a basic lesson in the business world, but one that some seem to forget. The latest example – actually there are two – comes courtesy of Grace-Marie Turner of the Galen Institute. Ms Turner sent me an email, copied below.”

Read on and then say it with me, “Oh, snap!”

Luntz to GOP: Health reform is popular – Politico.com Print View

Luntz to GOP: Health reform is popular – Politico.com Print View: “Luntz’s 10 pointers in “The Language of Healthcare 2009”:

(1) Humanize your approach. Abandon and exile ALL references to the “healthcare system.” From now on, healthcare is about people. Before you speak, think of the three components of tone that matter most: Individualize. Personalize. Humanize.”

You know, pretend to be human, to care, to have a soul, and all that liberal sissy stuff.

There’s lots more from the master of manipulative language

Fraser Institute still allowed space in WSJ

A friend sent me this piece from the WSJ from the seriously delusional Fraser Institute (whom I may have to give their own subject tag at this point, but I’ll stick them in with the Right Wing Noise Machine for now). My reply:

I love how these people love to site anecdotes. I note they never site the horrible anecdotes from the US.

I have some collected here: http://cmhmd.blogspot.com/search/label/%22Anecdote-Off%22

The first entry on my blog in my “anecdote-off” section is from a BBC documentary on US healthcare from January.

Have fun. See how many anecdotes you can count in this brief half hour program. I think there are at least a thousand if you count all those poor people at the RAM Medical program. But there are stories every bit, actually worse, than any Canadian anecdote I’ve ever seen.

Keep scrolling down, you’ll get the idea. If you are uninsured in America, you may as well be in Cambodia until you’re sick enough for the ER.

Oh, and hip replacements in the US do have a short waiting time, thanks to OUR single payer system, Medicare, which is funded well enough to make it so,

And finally, the Fraser Institute is full of poopy-heads, and dishonest ones at that. 😉

I love you, but aren’t you seriously tired of being systematically manipulated by Fraser, Heritage, Club for Growth and the rest of the noise machine?

Cheers,

Texas still leads nation in rate of uninsured residents | Dallas Morning News | News for Dallas, Texas | Dallas Business News

Texas still leads nation in rate of uninsured residents Dallas Morning News News for Dallas, Texas Dallas Business News:

“But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. Mr. Goodman, who helped craft Sen. John McCain’s health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)

‘So I have a solution. And it will cost not one thin dime,’ Mr. Goodman said. ‘The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American – even illegal aliens – as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.

‘So, there you have it. Voila! Problem solved.'”

Wow. Breathtaking, isn’t it?

Canada’s health care has ’em lining up – Pittsburgh Tribune-Review

Canada’s health care has ’em lining up – Pittsburgh Tribune-Review

Coverage of the SEPP-PNHP event at Duquesne of March 10.
Not too shabby for the Scaife-Tribune, but my expectations are rather low.

My post on the event is here.

And the Waiting time section here.

Single Payer Debate at Duquesne U, 3/10/08

SEPP Organization – SEPP Events

(The link above takes you to the details of the event.)

I attended the debate last night among Dr. Scott Tyson and Gariel Silverman, arguing the single payer case, and Sue Blevins and Nameed Esmail, arguing against at Duquesne University last night. First, props to Duquesne: Great venue in the Power Center, easy parking, nice facility all around. And props to both groups for getting attendance to a surprisingly high level (over 200, I’d guess). Pro-single payer were in the majority, I’d guess, by a significant amount.

I’ll cut to the chase: Jerry Bowyer, moderator, at the end of the evening, asked if the discussion had changed anyone from their pro or anti single payer or undecided camps, and only a handful of hands went up. Sigh. But, not, of course, unexpected.

To those of us who are familiar with the issues and arguments for and against single payer, and familiar with the players (esp. Mr. Esmail’s Fraser Institute), there were not many surprises. My most pleasant surprise was Dr. Tyson’s excellent performance. Powerful, personal and passionate, Dr. Tyson did a very good job of making the moral, practical and economic case.

As my bias is obvious, I won’t pretend to disguise it. I found the same old arguments from the status quo/free market/every man for himself side very tiresome indeed. I’ll just toss out a few “highlights.”

Single Payer advocates see Canada as a Panacea solution for America’s woes. I don’t know of any, but it somehow forces single payer advocates into the silly position of defending Canada’s system, even though it is not the one we would emulate. From now on, we should respond to the Canada graphics with ones comparing us to Germany, France, Belgium, Japan, or almost anyone, and leave Fraser to shit on their own country as they seem wont to do. Heaven forbid they offer constructive solutions. And by this, I mean ones that at least 30 or 40% of the Canadian population would at least consider.

Showing a spending chart showing Canada at the high end of spending on healthcare compared to the rest of the world, and omitting the US, cause we’re so off the charts as to make the chart look laughable.

Arguing that taxation sufficient to pay for healthcare would strangle economic growth. This is just too brain-dead to answer, especially sitting in a country that spends 16.5% of its GDP on healthcare. And especially from an economist who said, specifically, that there is no “government money” only our money in government’s hands.

Waiting times in Canada are intolerable and/or deadly. Please click here.

$32 Billion in Medicare fraud annually is an outrage and a scandal. I don’t know the source or veracity of this figure, but the 2006 Medicare expenditures were $408 billion, meaning 92% of the money gets where it’s supposed to, which needs work, but isn’t awful. And the suggestion that I think Ms. Blevins made was that she preferred private insurer’s solution: deny care first, and then sort out who was trying to scam you, rather than covering claims in good faith and then going after the perps. I’m all for getting the perps, but not until I’ve made sure the patients are taken care of first. Silly me.

Patients in Canada often have to wait 10 or 12 hours to get a hospital bed when admitted through the ER. Imagine our shock. (He did know Pittsburgh was in America, right?)

Veterans Administration hospitals are horrible places. Dr. Tyson did try to set Ms. Blevins right on this one, though I think she didn’t believe him.

You cannot pay for treatment in Pennsylvania outside of your contract with your health insurer.
This one got my attention. I hope somebody will post a comment for me about it, because I’d never heard this before, and it seems exceedingly odd.

The usual “anecdote-off,” for which I’ll just refer you to our special section.

I was pleased to see Mr. Esmail’s praise of other systems, particularly those of Switzerland, Japan, France, Sweden, Germany and some others. He rightly pointed out that the old PNHP proposal, from 1993, was fairly beholden to the Canadian model, but there are newer proposals from PNHP, and besides, they are not the only proposals out there. As has been often pointed out by our side, and always ignored by theirs, we need a uniquely American system, pulling from the best of all other extant systems. Though Mr. Esmail did seem gratified to sear Dr. Tyson say this, I doubt it was the first time he heard it. (You don’t suppose he didn’t watch Sicko, even as an academic exercise?) Oh, and Esmail even admitted we were rubbish for Mental Health care, too.

Oh, and a personal shout out to Scott Tyson for his wonderfully dismissive treatment of HSAs. Made me chuckle and even snort a bit!

OK, folks, that’s all I can remember at this late hour, but please add your comments to remind me of things I forgot to mention….

Cheers,

Britain’s health care amounts to malpractice – BostonHerald.com

Britain’s health care amounts to malpractice – BostonHerald.com

I don’t know of a person who advocates for universal health care in the US who advocates for a nationalized system such as Britain’s that the author holds up as his bogeyman. The discussion is about which type of single payer system or universal insurance coverage scheme we should adapt to the US. As Michael Moore has stated, we aren’t talking about blindly adopting another contry’s system wholesale, we are talking about having a policy discussion and creating a uniquely American system, emphasizing our strengths and remedying our weaknesses.

But what really prompted me to write this were a couple of absurd statements by the author.

First, “No one can complain that the NHS is underfinanced. This year’s budget is $210 billion – about $1.05 trillion if adjusted to match America’s population.” Really, no one? The Internets have this thing called “Google” and if you search for “NHS underfunded” you might find out that at least a few people (Tony Blair, for one) who believe it is underfunded. But more importantly, is there anyone who doesn’t get that we spend roughly twice as much per person on healthcare and get terribly shaky outcomes for it? Specifically, is there anyone writing a piece for a major newspaper who doesn’t know this?

And this: “A September 2007 Lancet Oncology article found 66.3 percent of American men alive five years after cancer diagnosis. Only 44.8 percent of Englishmen survived after five years. Across the European Union, 20.1 females per 100,000 under 65 died prematurely of circulatory disease. Among British women, that number was 23.6.”

Here’s an interesting table from that study, showing the UK NHS as the worst, except for Slovenia, Iceland, Poland and the Czech Republic. And I’ll say it again, nobody wants to replicate the British system here. And for more comparisons on US versus other countries healthcare outcomes, go here.

And, finally, my favorite, “Within this maze, patient needs often yield to the wants of pols and medicrats.” Go see Sicko, man! Are you kidding? You think we don’t have pols in the hands of Pharma and the health insurance and health care industries and “medicrats” at our insurers? Who do you think draws those multi-million dollar salaries at the Blues and Aetna and the rest?
Aren’t these people getting tired of flogging this dead dog? Probably not, because apparently that dog still hunts in the imaginations of some.

Cheers,

Boston herald:

I don’t know of a person who advocates for universal health care in the US who advocates for a nationalized system such as Britain’s that the author holds up as his bogeyman. The discussion is about which type of single payer system or universal insurance coverage scheme we should adapt to the US. As Michael Moore has stated, we aren’t talking about blindly adopting another contry’s system wholesale, we are talking about having a policy discussion and creating a uniquely American system, emphasizing our strengths and remedying our weaknesses.
But what really prompted me to write this were a couple of absurd statements by the author.
First, “No one can complain that the NHS is underfinanced. This year’s budget is $210 billion – about $1.05 trillion if adjusted to match America’s population.” Really, no one? The Internets have this thing called “Google” and if you search for “NHS underfunded” you might find out that at least a few people (Tony Blair, for one) who believe it is underfunded. But more importantly, is there anyone who doesn’t get that we spend roughly twice as much per person on healthcare and get terribly shaky outcomes for it? Specifically, is there anyone writing a piece for a major newspaper who doesn’t know this?
And this: “A September 2007 Lancet Oncology article found 66.3 percent of American men alive five years after cancer diagnosis. Only 44.8 percent of Englishmen survived after five years. Across the European Union, 20.1 females per 100,000 under 65 died prematurely of circulatory disease. Among British women, that number was 23.6.”
Here’s an interesting table from that study, showing the UK NHS as the worst, except for Slovenia, Iceland, Poland and the Czech Republic. And I’ll say it again, nobody wants to replicate the British system here. And for more comparisons on US versus other countries healthcare outcomes, go here.
And, finally, my favorite, “Within this maze, patient needs often yield to the wants of pols and medicrats.” Go see Sicko, man! Are you kidding? You think we don’t have pols in the hands of Pharma and the health insurance and health care industries and “medicrats” at our insurers? Who do you think draws those multi-million dollar salaries at the Blues and Aetna and the rest?
Aren’t these people getting tired of flogging this dead dog? Probably not, because apparently that dog still hunts in the imaginations of some.
Cheers,

heritage foundation – Moral costs of socializedmedicine

Vindy.com News – Youngstown, Ohio – Moral costs of socializedmedicine:

“Anyone who considers Canada’s health system a role model for the U.S. should consider the case of Samuel Golubchuk. His case shows the inevitable collision course between government-controlled health care and the rights of private conscience.”

Typical hack rubbish. My comments are on the Vindy web site below the article…