Sunday, June 21, 2009

White House Stands by Obama's Claim That Single-Payer Health Care Works In Other Countries--It's Just Not Sure Which Countries Obama Meant

Two days after President Barack Obama told the American Medical Association that in some countries a single-payer health care system “works pretty well,” the White House reaffirmed that people in those countries liked their health care, but also said it did not know to which countries the president was referring. “I don’t know exactly the countries. I think if you talk to the people in the countries that have that system, they think their health care is pretty good,” White House Press Secretary Robert Gibbs told Wednesday during the daily press briefing.

Asked again if he knew specifically which countries, Gibbs replied: “I assume Canada, Britain, maybe France. I don’t know the exact countries, but again, I don’t think the president is going way out on a limb that some people in other countries have a health care system that they like. Just as some Americans like the health care system that they have.”

President Obama spoke Monday in Chicago to the American Medical Association, the doctors’ lobby that is skeptical about his “public option” health care reform proposal.

“Let me also say that—let me also address an illegitimate concern that’s being put forward by those who are claiming a public option is somehow a Trojan Horse for a single-payer system,” Obama said on Monday.

“I’ll be honest, there are countries where a single-payer system works pretty well. But I believe – and I’ve taken some flak from members of my own party for this belief – that it’s important for our efforts to build on our traditions here in the United States. So when you hear the naysayers claim that I’m trying to bring about government-run health care, know this: They’re not telling the truth.”

The criticism of single-payer health care – primarily as practiced in Canada and Europe – has been that operations and procedures are long-delayed or denied and health care is rationed to control costs. For example, in Canada, the average wait for a 65-year-old man to get a hip replacement is six months, according to the Freedom Works Foundation.

The average wait time in a Canadian emergency room is 16 hours and 18 minutes. Also, “the average cancer test and radiation treatment cycles vary between 6 to 8 weeks,” the foundation reported.

John Goodman, director of the National Center for Policy Analysis and author of the book, “Lives at Risk: Single-Payer National Health Insurance Around the World,” has reported that in Britain, “at any one time, there are about a million people waiting to get into hospitals. According to the Fraser Institute, almost 900,000 Canadian patients are on the waiting list at any point in time. And, according to the New Zealand government, 90,000 people are on the waiting lists there.”

“Those people constitute only about 1 to 2 percent of the population in those countries, but keep in mind that only about 15 percent of the population actually enters a hospital each year,” says Goodman. “Many of the people waiting are waiting in pain. Many are risking their lives by waiting. And there is no market mechanism in these countries to get care to people who need it first.”

Earlier this year, the Obama administration signed an economic recovery act into law that established a comparative effectiveness council to determine the most cost-effective medical procedures. This economic stimulus bill also included the establishment of a centrally linked electronic infrastructure that would include the medical information of every American by 2014.

Obama and most Democrats in Congress are pushing for a “public option,” or government-run health insurance program that would compete with private health care companies.

Many analysts agree that the private, market-driven companies would be unable to compete with a government-run insurance program, which would have nearly unlimited resources.


Don't get old and sick in Obama's America

By R. Emmett Tyrrell, Jr.

If you have any sense that you may be getting sick in the years ahead, I suggest you get sick immediately. If you will be in need of surgery or any other medical procedure, do it now! If not immediately, be certain that you hand yourself over to the healthcare professionals before October 15 of this year. That is the date on which President Barack Obama hopes to sign his healthcare bill once it has gone through the congressional baloney grinder.

At the heart of President Obama's plan is his stated goal to cut medical costs. That might sound good to you, but it means cutting services, nurses, technicians, medical tests, and most prominently the use of expensive technology. The President's top medical advisers are quite frank about this. Dr. Ezekiel Emanuel, brother of Rahm Emanuel and a health policy adviser in the Office of Management and Budget, has chided Americans for the expense of their "being enamored with technology." Dr. David Blumenthal, another key Obama adviser, charges medical innovations as being responsible for fully two-thirds of the annual increase in healthcare spending. Their solution is to limit expensive innovations. A 2008 Congressional Budget Office report agrees with their cost analysis but concludes happily that such innovations "permit the treatment of previously untreatable conditions." As I shall show, there are more humane ways to cut healthcare costs.

Also at the heart of President Obama's plan is the restriction of services for older people, people 65 and older who by virtue of modern medicine may actually be ten and fifteen years younger in terms of good health than they would have been a generation ago. Alas, they still have higher health risks and costs than younger people. Thus they are going to bear the brunt of the Obama Administration's cost cuts, for 27-30% of Medicaid spending is spent for caring for people at the end of their lives. With the government taking over more of the nation's healthcare costs under the Obama regime, it has already been decided that government monies are more economically spent on younger people than on older people. If a 65-year-old needs a hip replacement, the government will better spend that money on a younger person whose hip will last longer. Or perhaps the government will decide the money is better spent on preventive medicine for younger people.

In the federal stimulus legislation that the president signed February 17, we find funding for a Federal Council on Comparative Effectiveness Research. "Comparative effectiveness research" is a term used by economists in healthcare for making health comparisons based often on age and for limiting care based on a patient's age. In Great Britain comparative effectiveness research is actually used to deny patients treatment for age-related diseases such as heart disease and macular degeneration. When the federal stimulus bill was going through Congress there were warnings regarding the consequences of comparative effectiveness research. Rep. Charles Boustany Jr., a heart surgeon, warned that it would lead to "denying seniors and the disabled lifesaving care."

Yet the policy remained in the bill along with requirements for doctors' offices and hospitals to maintain data banks on patients while creating a national network to monitor patients' care. The good side of that is that a central data base can send out the latest information on treatments, though doctors who keep up with their medical journals already know about these treatments. The dark side is that it will allow the federal government to control how our doctors treat us. The bill speaks of "appropriate" and "cost-effective" care and provides penalties against doctors beginning in 2014. Now there is an Orwellian twist to the Obama promise of "hope" and "change."

As Betsy McCaughey has written in a groundbreaking analysis of the Obama healthcare proposals, draconian cost-control measures are not the answer to healthcare reform and they are based on erroneous data. Healthcare's spending increases over the past five years have been about half what they were in the recent period before that. Average family spending on food, energy, and healthcare have remained the same for decades. Moreover, contrary to myth, there are not 47 million uninsured Americans but actually about 22 million. Rather than pass a healthcare reform that will mercilessly limit healthcare to older citizens (and to chronically ill citizens) while still increasing federal expenditures by at least a trillion dollars, she suggests a modest reform, to wit, debit cards for the uninsured and the needy.

Appearing in a recent installment of, McCaughey wrote, "Providing sliding scale assistance, based on household income, to families to purchase…coverage would cost $20 to $25 billion a year." That is one reform that will deal with our present problems. There are others, which I shall take up in later columns. What we do not need is Orwell's Big Brother overseeing the rationing of healthcare to senior citizens, particularly senior citizens with years of life ahead of them.


The Nation's Medicine, when will they ever learn?

A dialogue

So tell me again why you aren't a doctor. Because my father - an Edinburgh-trained general physician and surgeon - urged his son against it. He foresaw the day, now rushing at us, when the federal government would be setting rates, approving procedures, and broadly regulating the medical profession.

President Obama and congressional Democrats want to extend medical insurance coverage to everyone, drive down health-care costs, and raise the quality of care. They're talking about a "public option" plan to show the way by competing with private-sector insurance plans. What's the matter with that?

All three cannot be done. And the "public option" - the government plan - inevitably will become the only option, hence the only plan. But the president isn't saying that. In his remarks to the American Medical Association, he told the nation's doctors, "The public option is not your enemy; it is your friend."

Sort of like, I'm from the government, and I'm here to help you. Thoreau had it right when he wrote, "If I knew for a certainty that a man were coming to my door with the conscious purpose of doing me good, I would run for my life."

At the AMA, the president talked about people like you, who dismiss his proposals as "socialized medicine" or nationalized care. The hour for reform and change is at hand. Instead of being part of the problem, why don't you become part of the solution - and join the debate? OK. For openers, try on these quotes:

1) Liberal economics columnist Robert Samuelson: "It's hard to know whether President Obama's health care 'reform' is naive, hypocritical, or simply dishonest. Probably all three. The president keeps saying it's imperative to control runaway health spending. He's right. The trouble is that what's being promoted as health care 'reform' almost certainly won't suppress spending and, quite probably, will do the opposite."

2) The conservative Heritage Foundation's Robert Moffit, on the president's AMA speech: "He reiterated the key elements of his health policy agenda: a new government-run health plan to compete with private health plans in a government-run national health insurance exchange. It would include a government mandate on employers to offer government-approved coverage, as well as a government mandate on individuals to buy government-approved insurance."

3) Professor Scott Harrington of the University of Pennsylvania's Wharton School: "In reality, equal competition between a public plan and private plans would be impossible. The public plan would inexorably crowd out private plans, leading to a single-payer system. ... Health-care providers and other Americans should recognize this reality and be prepared for the consequences."

YOU obviously agree with those observations. Why? For a number of reasons. Government estimates of the costs of things - in this case, $1.5 trillion over the next decade alone - always are notoriously wrong on the low side. Not always. Yes, always. Way low.

Next, there's medicine and there's inferior government-run medicine - just as there's the car business and (soon) the government-run car business, education and public (i.e. government-run) education. Where - anywhere - is government-run medicine better in terms of quality and efficiency of delivery than the private medicine available throughout the United States? If there were even a single example, it would be page-one news every day.

So? So Obama and his rubber-stamp congressional lefties are hell-bent to Europeanize the nation's health care with state-run (yes, socialized) medicine. To borrow from two old songs, Give 'em the ol' razzle-dazzle and Promise 'em anything, but give 'em socialized medicine. Waits will grow longer, costs will go up, and quality of care will go down. It doesn't make any sense.

WHAT would make sense? Politically, we probably have reached a time when the government has to mandate health care coverage for everyone. It could do that simply by requiring every taxpayer to attach to his federal tax return a certificate of coverage for him and his dependents. (Non-taxpayers would get medical care through a pool funded in any of various ways.) Then private insurance carriers would compete to sell state-sanctioned plans at the lowest costs for a multitude of coverage ranges.

That sounds a lot like the Federal Employees Health Benefits Plan under which congresspersons and presidents buy their medical coverage. Bingo. Very much like that - and there was a time when Obama was suggesting it, but apparently not anymore. If such an arrangement is good for lofty congresspersons and presidents, is it too good for the everyday rest of us? Wow. A plan already in place - and used by the president himself. Why isn't he using it as a model for the country?

Because he is a statist at heart - and he has the popular support and the votes in Congress to socialize medicine on the European model. And despite his tendency to complexify things and conceal them in an inky rhetorical cloud, that's clearly what he wants to do - and that's what we're likely to get, and don't bring up the new taxes that will be imposed in its name.

Complexify, Europeanize, socialize? Indeed. With the consequent rationing that defines care restrictions and price controls - and the tearing up of the private doctor-patient contract that is the essence of American medicine. That's the freight train rushing at us.

Your father actually foresaw this? He did - and in many ways the train already has arrived, which helps explain the smoldering fury of many of the nation's physicians. The new regime seems set on replacing private medicine with government medicine. In the slang acronym, we face a HICA moment. HICA? For Here It Comes Again.


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