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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?


To: Lane3 who wrote (7930)7/31/2009 8:44:14 AM
From: Brumar891 Recommendation  Read Replies (1) | Respond to of 42652
 
He does the procedure because he was taught it in med school, the procedure has become the standard protocol for the ailment, and all his fellows do it. Either no one has studied outcome data or the fact that the procedure isn't effective or cost effective hasn't yet seeped into the set of protocols that doctors follow.

I have to think doctors are generally more up on the latest developments and findings in their field than someone who works for a government office would be.

Still, a government expression of the lack of utility of a particular procedure should give medical practitioners some cover in lawsuits even without tort reform. It could be seen as a back-door contributor to tort reform. Right now lawsuits are based on doctors failing to do something that is part of the accepted protocol. If the protocol changes because of what the government discovers about outcomes, then the doctor is in the clear.

John Edwards got filthy rich convincing juries that things within standard protocols wasn't good enough.



To: Lane3 who wrote (7930)7/31/2009 8:57:46 AM
From: Road Walker  Read Replies (3) | Respond to of 42652
 
THE FIFTH COLUMNIST by P.M. Carpenter

Maybe it's not hardwired in all human animals, but it unquestionably is in the American species: that headlong eagerness to accept dark rumors before upbeat facts, to relish the luringly sordid over the passably virtuous, to embrace the cynical tale while discounting the positive -- all of which is why, for instance, those biennially grainy, slo-mo, B&W negative political ads work so consistently well.

It's also why, as the New York Times reports, "President Obama's ability to shape the debate on health care appears to be eroding," as evidenced by the paper's polling of his 10-point approval-rating drop since April, as well as other statistical downers, such as the NBC/Wall Street Journal's finding that only 36 percent now ordain Obama's health-care plan "a good idea."

After all, consider which is the sexier in this double helix of unfolding events: Obama's "opponents," says the Times, "aggressively portray his overhaul plan as a government takeover" (as Obama counters that "nobody is talking about some government takeover of health care"), and "that," continues the reporting, "could limit Americans' ability to choose their doctors and course of treatment" (against which Obama then parries, "Under the reform I've proposed, if you like your doctor, you keep your doctor; if you like your health care plan, you keep your health care plan.")

No contest. Foreboding tales of despotic takeovers and brutal limitations will memorably capture the eye, ear, and brain, well before any defensive thrashings about. The former sticks, while the latter is greeted by, Yeah, but what about ...

Such is the enduring pitfall of any real reform; its proponents first paint a more pleasant world as a result, its opponents then hasten to denounce every conceivable downside in funereal, overwrought tones. In short, the naysayers can pick it to death -- and given today's cable-news freak shows and hysterical Internet rumormongering, the pickings are even easier.

What's odd about the current debate's contours is that the White House, according to the Washington Post, believed it had launched its call for health-care reform in its own fundamentally negative terms, which, in this negative-loving nation, was considered a positive. "President Obama has framed the health-care debate in Washington as a campaign against the big, bad insurance companies," reports today's Post, and "the message is no accident."

Joel Benenson, Obama's top pollster, last month told the Economic Club of Canada "that extensive polling revealed to the White House what many there already had guessed: People hate insurance companies"; Benenson also volunteered that "many pollsters believe voters are 'rational and logical,' while his team also focuses on their fears and emotions."

Well, Joel, about all one can guess is that your initial launch wasn't volubly, rivetingly negative enough. But if you really want to fan proper fear and emotion, try reminding folks that the people who brought them the worst economic devastation in generations and a wholly unnecessary war are the very same people who are now merchandising tepid reform and stigmatizing the real thing.

Another factor contributing to the erosion of "Obama's ability to shape the debate on health care" is that when we collectively ponder Obama's health-care proposal, we don't really know what we're pondering, since Obama himself has never had a fixed plan. Granted, this policy ellipsis was probably unavoidable, since Obama, a student of history, appreciated the lapidary, on-high catastrophes of the Clinton era; hence in this respect Obama was likely damned if he didn't, damned if he did -- that is, settle and insist on a fixed, preconceived plan.

Encouragingly, however, while in the NBC/WSJ poll only 36 percent said Obama's plan -- in whatever form they understood it -- was "a good idea," when offered knowable details of the plan the favorable percentage shot up to 56. Rather discouraging, on two other hands, are that "the description given to poll respondents didn't include a public-insurance plan," so we've no better idea of where that stands, plus NBC and the Wall Street Journal can't call 300 million Americans with informative tips before polling.

Besides, in the long run that most malevolent political axiom always comes back to haunt: When you're explaining, you're losing. In chess, play nothing but defense against a grandmaster and you'll get your ass kicked every time (against a grandmaster I would anyway, but you get the point); in politics, same strategy, same result, against reactionary grandmasters of splenetic propaganda. They'll box you in and have you thrashing about, just before you drop dead from exhaustion.

Or perhaps a military metaphor would better inspire the White House to greater heights of determined animation; let's say, the 1944 unbowdlerized words of Gen. George Patton to his troops: "I don't want to get any messages saying, 'I am holding my position.' We are not holding a goddamned thing. Let the [reactionaries] do that. We are advancing constantly and we are not interested in holding onto anything, except the enemy's balls. We are going to twist his balls and kick the living shit out of him all of the time. Our basic plan of operation is to advance and to keep on advancing regardless of whether we have to go over, under, or through the enemy. We are going to go through him like crap through a goose, like shit through a tin horn."

Yes, that's it; just about time for a nice, clean kill.

THE FIFTH COLUMNIST by P.M. Carpenter



To: Lane3 who wrote (7930)7/31/2009 10:42:07 AM
From: Brumar893 Recommendations  Read Replies (2) | Respond to of 42652
 
I'd like to reiterate that its a mistake to expect that our legislators will produce wise, smart or efffective legislation in the healthcare area. Particularly now that we have Congressional leaders openly mocking the idea of even reading the legislation they vote for.

Take a look at a few things from another area - energy policy:

1) We have a corn ethanol industry created by government mandates and subsides that makes no financial or energy sense.

2) Consider the cash for clunkers programs moving goalposts:

Many people who thought they were eligible to benefit from "Cash for Clunkers" rebate and made a deal for a new car out this week found that they are not. It seems that just before the program was to go into effect on July 24 the EPA changed its fuel efficiency ratings on many models. According to CNN Money:

...as part of the official launch, the EPA conducted "quality assurance and quality control effort regarding fuel economy calculations on more than 30,000 vehicle model types spanning the past 25 years," according to an e-mail sent by EPA spokesman Dale Kemery.

As a result, eligibility for roughly 100 vehicles was affected, Kemery wrote. However, roughly equal numbers became newly eligible and newly ineligible.

Since it is the National Highway Traffic Safety Administration that administers the rebate program, one might wonder if one part of the Government knows exactly what the other is doing. This is particularly the case here since the benefits were retroactive to July 1. Thus dealers were entering into agreements with customers based on the published MPG figures found at fueleconomy.gov and waiting until July 24 to file for the rebate itself. When those published figures changed without warning, ...


Message 25821556

3) Consider the substitution of clean expensive wind power for clean cheap hydro power (that is discarded) in the Columbia river basin as a result of government mandates and subsidies:

In the space of one hour last month, electricity generated at wind farms in the eastern end of the Columbia River Gorge shot up by 1,000 megawatts – enough to power some 680,000 homes.

Less than an hour later, it plummeted almost as much.

Sitting in front of 10 computer screens in a fifth-floor room of the federal Bonneville Power Administration headquarters in Portland, Kim Randolph had to react quickly.

Working from a keyboard, she diverted millions of gallons of water away from massive turbines spinning in Columbia River dams and sent it around the dams.
...despite the electricity it is putting in the grid, wind is contributing…nothing. Note that when wind production is surging, the utility is sending water around the turbines of the dam. That lost potential energy is gone forever. All the wind power did in this case is substitute for clean hydro power.
It has no value in this particular case (beyond the ability of the utility to put wind on its annual report and seek subsidies from the Obama administration).


Message 25826950

Our legislators are ignorant (and now brazenly arrogant about that ignorance) and corrupt and the legislation they produce reflects that.

The idea of people who produced the stupid wasteful boondoggles listed above being in charge of our health care should scare the crap out of people.

BTW I listed three examples of government absurdity in the energy policy. Cap and trade is an even greater example that the three items I chose, but covering its built in problems would take too much space here.