Sunday, February 28, 2010

Those wicked ophthalmologists

The political Left worldwide seems to regard everyone but themselves as responsible for high medical costs. The vast load of paperwork that they impose on healthcare providers and drug companies is costless, apparently. And the high incomes of some doctors frequently come under jealous scrutiny.

A high income group in Australia is ophthalmologists. Everyone wants the very best chance of preserving their vision so people are prepared to pay for a high level of care in eye-doctoring. And Australia's Federal Health Minister, Nicola Roxon, was determined to rein those rogue eye-doctors in.

As part of its socialized medicine system, called "Medicare", the Australian government pays a large part of the cost of privately-contracted ophthalmological services, so Ms Roxon thought she had a good weapon to cut those rich eye-doctors down to size: She would halve the amount that her government pays for such services.

The conservatives in the Senate knocked back Ms Roxon's "reforms" however, so she eventually had to accept a compromise deal which cut the government payment by only 12%.

As it happens, all this affects me personally to a minor extent: I will shortly be having a cataract procedure on my right eye from a well established and formidably equipped private ophthalmological practice a short drive from where in live in Brisbane. So my ophthalmologist explained the cost structure to me.

The cost now includes a "facility fee" -- a fee for use of a private operating theatre that is common for most types of private medical procedures. I pay a similar fee when I go to my dermatologist to have skin cancers excised. The ophthalmologist remarked to me that they used not to charge such a fee. They used to absorb it into their general fees. But after Ms Roxon's "reforms", they have instituted such a fee.

So the income of the ophthalmologists remains largely the same. Ms Roxon's attack on them has been futile. What they lost on the swings, they gained on the roundabouts.

But what about the patients? Here's the catch: Facility fees do NOT attract any government refund. So the patient pays more. The government has indeed saved itself a bit of money, but at the expense of the patients, not at the expense of the doctors: A typical "unforeseen" result of Leftist intervention.

Ailing Health Care

Make no mistake: If President Barack Obama actually wanted to be the post-partisan agent of Washington change, his health-care summit would have looked a whole lot different than the meeting he recently held across the street from the White House. Every Republican, from House Minority Leader John Boehner to maverick John McCain (the latter facing primary challenger from the right, by the way) walked into the meeting imploring the White House to start over, to begin again, to hit the reset button. If the president wanted to work with them in any way, he would have done just that.

Instead the president continues to argue -- aided by media folks from near everyone on MSNBC to even Bill O'Reilly on the supposedly all-right Fox News Channel -- that the American people just don't understand what his health-care plan is all about. In one sense, I agree with him. Given the fact that even the Congressional Budget Office said it didn't have enough details to do a proper examination of the latest version of the legislation in time for the official summit, the man has a point. But it's not voters' slowness that's the problem; it's the White House with the issues.

If the president were serious about being a different kind of leader, he would have invited governors at the White House summit on health care, as Republican politicians requested.

Instead of dismissing criticisms as he has been doing for the better part of a year now in this and other debates, President Obama should have considered what Republicans had to say. One of the best lines of the summit was: "If you're waiting for Mitch McConnell to roll in here a wheelbarrow full of a 2,700-page comprehensive health-care bill, that's not going to happen," delivered by Republican Sen. Lamar Alexander. He continued, "We've watched the comprehensive, economy-wide, cap and trade. We've watched the comprehensive immigration bill ... we've watched the comprehensive health-care bill. And they fall of their own weight."

That's a message that Washington can afford to hear. That's a message that gets back to constitutional principles of federalism. And, frankly, that's a manageable message.

As Paul Ryan, a congressman from Wisconsin, whose attention to detail is such that even the president has trouble dismissing him, explained, "We don't really believe the government should be in control of all this." Pointing to what he and others have been hearing from Americans -- in town halls since the summer and perhaps most recently in the Massachusetts special election, Ryan said to the president: "I would respectfully submit: You're not listening to them."

Not listening isn't exactly the "hope and change" people signed up for. The president of the United States is a liberal ideologue who isn't comfortable telling you the straight facts. And he ridicules those who try to highlight the truth. Without a penchant for honesty -- or even a slight openness to it -- it's just about all he's left with.

On perhaps no issue is this more obvious than abortion. And it's been so with President Obama since before he was inaugurated. During the campaign, he falsified his position and called those who talked about his record in the Illinois statehouse liars. He continues to do just that. Late last year, he audaciously accused the Catholic bishops of the United States and others who criticized various versions of the health-care legislation for providing federal dollars for abortions of "bearing false witness" on the issue. And, after refusing to invite pro-life Rep. Bart Stupak, a Democrat, to the summit, when Rep. Boehner brought the issue of abortion up, the president of the United States simply ignored the minority leader. He apparently didn't believe that an issue that threatens the consciences of millions of Americans deserved a simple explanation from the White House.

A Quinnipiac poll last year found that 72 percent of voters oppose federal funding of abortion. A recent CBS poll found that half those surveyed didn't approve of the president's job on health care.

There's something to what Rep. Ryan said. And President Obama knows it or he wouldn't be trying so hard to gloss over what he's doing, and to dismiss criticisms. His options right now are to force some plan through Congress or walk away, blaming the "party of no" for killing his health-care hopes. But his own health-care summit is already on YouTube and provides ample fodder to counter his party's obstructionist Republicans. His opposition proved themselves anything but the troglodytes "Hardball" would have them portrayed as.

And if the president does manage to get enough Democrats to go along with his politically suicidal gambit, good luck explaining why the impractical plan is not the panacea it was supposed to be. And then the American people will understand things all too well.


Someone Needs to Tell the President His Health Care Plan is Dead

The day before yesterday’s White House health care summit, Sen. Kent Conrad (D-ND) told reporters: “The only way this works is for the House to pass the Senate bill and then, depending on what the package is, the reconciliation provision that moves first through the House and then comes here.” When Conrad was reminded that Speaker Nancy Pelosi (D-CA) has repeatedly insisted that the House will not pass the Senate bill until the Senate passes a second bill that fixes the first, Conrad replied: “Fine, then it’s dead.”

This was the dynamic that President Barack Obama was trying to alter with his eventually-seven-hour meeting. And judging by pretty much every major news outlet, he completely failed. Rep. Jason Altmire (D-PA), who is one of the 39 House Democrats that the White House needs to switch from a “no” the first time around to a “yes” this time, told The New York Times: “I don’t see very many at all who voted no who are going to switch their votes unless there are substantial changes in the bill.”

And that reality is already spreading throughout Capitol Hill. Politico reports that while Democrats were hoping to pass Obamacare by Easter, “there were signs Thursday night that the schedule was slipping. One Democratic lawmaker involved in the negotiations, who asked not to be identified to speak candidly of the process, said the party would not, in fact, start down the path of reconciliation next week.”

That is some rare great news for the American people. As Rep. Paul Ryan (R-WI) ably explained yesterday, Americans do not want Washington dictating their health care decisions to them, and that is exactly what Obamacare would do:
The difference is this: We don’t think all the answers lie in Washington regulating all of this. … if the National Restaurant Association or the National Federation of Independent Business, on behalf of their members, wants to set up an association health plan, we think they’ll probably do a good job on behalf of their members. Let them decide to do that instead of restricting insurance competition by federalizing the regulation of insurance, and by mandating exactly how it will work, you make it more expensive and you reduce the competition among insurers for people’s business. We want to decentralize the system, give more power to small businesses, more power to individuals, and make insurers compete more. But if you federalize it and standardize it and mandate it, you do not achieve that. And that’s the big difference we have.

President Obama bristled at this analysis, responding: “Can I just say that, at this point, any time that a question is phrased as, “Does Washington know better,” I think we’re kind of tipping the scales a little bit there since we all know that everybody is angry at Washington right now.”

The President seems to understand that the American people do not want bureaucrats in Washington controlling their health care decisions, but then he seems completely oblivious to the fact that increasing bureaucratic control at the expense of every American’s ability to make their own choices is exactly what his plan does.

The American people know this. That is why support for the President’s health care plan has been steadily declining. That is why the most recent CBS News/New York Times Poll shows 53% of Americans say the United States cannot afford to fix health care at this time. It is why 52% of Americans tell Gallup they do not want to see Obamacare pass with only 50 Senators in support (Vice President Joe Biden casting the 51st vote). That is why 59% of registered voters tell Fox News they want the President to start over.

And he should. If the President truly wants to enact historic bipartisan and lasting health care reform, he needs to admit this version of Obamacare is dead. In 2011, when there is likely to be a more centrist Congress in place, then Obama should come back and start again.


The Democrats' Problem

The Democrats did themselves no favors yesterday. The President did plenty to diminish himself. First, there was his lack of grace-- announcing,"I'm the President!," his testy reminder to John McCain about who won the election (reminiscent of his "I won" triumphalism immediately after inauguration), most notably -- and his penchant for scolding everyone was on display. Can anyone even imagine the really great presidents behaving this way? Can you imagine Ronald Reagan, or FDR (or even JFK or George HW Bush or George W Bush) hectoring, lecturing and condescending so brazenly?

Then there was the President's demonstrated inaccuracy about the fact that, contrary to his claims, his health care plan won't bring down health insurance premiums. So much for the brilliant policy wonk. Either he's dishonest, or he's wrong.

But the President's main problem -- and that of the Democrats generally -- is that it's clear it's not about America and its people anymore. It's about them. And that's political death.

When it comes to the President, it's clear that he wants his bill to pass so that he can have his way, and claim a big achievement, and vindicate his boasting about being the last president to have to tackle health care. And, of course, grow the size of government. It no longer has anything to do with actually solving a problem, or helping people, or reform. It's all about him. And it shows.

When it comes to the rest of the Democrats, they're in a similar boat. No one can claim that they're simply trying to respond to the cries for reform from the electorate. The electorate hates this bill. What seems most apparent is that they're trying to save their own skins, politically (there wouldn't be such a need for all the sob stories, otherwise -- that's called "overcompensation").

The President and the Democrats can try to claim they're doing this to "help" Americans. But voters apparently don't want this kind of "help." So it's patently obvious this is no longer about representing Americans or doing the will of the people.

It's about an out-of-control effort by the Democrats to impose their will on Americans, contrary to the people's expressed wishes. Americans know it, and they know it isn't about them -- they're seen by Dems as nothing but a stumbling block, at this point! -- and that's why there isn't any easy way for the Democrats to improve their political position.


ALG Blasts Obama for “Lying about the Increased Cost of Premiums” under Plan at Health Summit

Americans for Limited Government President Bill Wilson today condemned the Obama Administration for “lying about the increased cost of insurance premiums as reported by the Congressional Budget Office at his fraudulent ‘bipartisan’ health takeover summit.”

“Yesterday, Barack Obama flat out lied to the American people, claiming that his plan would, according to CBO, lower the cost of insurance premiums,” Wilson said.

Wilson pointed to the relevant Congressional Budget Office (CBO) report, which stated, “CBO and JCT estimate that the average premium per person covered (including dependents) for new nongroup policies would be about 10 percent to 13 percent higher in 2016 than the average premium for nongroup coverage in that same year under current law… Average premiums per policy in the nongroup market in 2016 would be roughly $5,800 for single policies and $15,200 for family policies under the proposal, compared with roughly $5,500 for single policies and $13,100 for family policies under current law.”

The CBO also reported, “About half of those enrollees would receive government subsidies that would reduce their costs well below the premiums that would be charged for such policies under current law,” which formed the basis of Obama’s claim, responding to Senator Lamar Alexander (R-TN), stating, “Lamar, when you mentioned earlier that you said premiums go up, that's just not the case, according to the Congressional Budget Office.”

Wilson said Obama was “misleading the American people. This is not a case where Obama and Alexander were ‘both right.’ Obama was wrong.”

Wilson explained, “Subsidizing premiums does not lower the cost of health care, it shifts the burden of the price of health coverage increasingly to taxpayers. At the same time, ObamaCare increases the minimum requirements for insurance coverage, which forces premiums up, as noted by the CBO.”

More here

Australia: Casualty department (emergency room) shutdowns in an already overstretched Sydney hospital system

Government logic at work

MOST seriously injured accident victims in the city and eastern suburbs will no longer be taken to St Vincent's or Prince of Wales hospitals under a new trauma plan. They will be forced to travel across town to either Royal Prince Alfred in Camperdown or St George Hospital in Kogarah. NSW Health has quietly released its trauma services plan after 10 years of wrangling among doctors. Under the plan, due to start on Monday, all major trauma patients will be diverted from Nepean to Westmead Hospital.

There are concerns about the ability of RPA, St George and Westmead to take on the hundreds of extra patients. RPA is expected to be most seriously affected as it and St George will need to absorb more than 400 extra patients a year.

The NSW chairman of the Australasian College for Emergency Medicine, Richard Paoloni, said RPA already had the highest level of ambulance arrivals in Sydney and the plan would increase pressure on emergency beds.

The Health Services Union, which represents paramedics, is concerned about increased "trolley block" - where patients are banked up waiting to get into emergency - as well as increased travel times to RPA and Westmead.

Although Nepean will still take trauma patients, the most serious will go directly to Westmead, which will increase the patient load by more than 200 this year. Westmead is already struggling to see its emergency patients on time. The latest performance figures show it is failing to meet benchmarks in three of the five triage categories and has the worst record in the state for admitting patients within eight hours - 63 per cent of patients, well below the benchmark of 80 per cent.

RPA is also failing to see all its emergency patients on time, and is not meeting benchmarks for two of the five triage categories. The Garling inquiry recommended just three adult trauma centres in Sydney.

Richard Matthews, the deputy director-general for strategic development for NSW Health, said the changes would strengthen hospital trauma systems and paramedics would still have the power to exercise their best clinical judgment. "If someone is stabbed seriously on the street outside St Vincent's the ambos will take them into the emergency department there. In the end, they've got the responsibility of making the clinical decision about what's best for the patient," Dr Matthews said. He said the hospitals affected had received extra funding but did not say how much.


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