The EU

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Wednesday, June 2, 2010

Nominated Head of Medicare and Medicaid

OK, I am late on this.  However, I just came across this blog posting on this nomination by President Obama.  Here we have a blog post (hat tip to Instapundit) on Human Services Secretary Kathleen Sebelius announcing that Dr. Donald Berwick, an advocate of health-care rationing, had been nominated by President Barack Obama to run Medicare and Medicaid.  For you young folks, that is the program us old folks depend upon for our health care—the programs that took big hits to pay for the Reid/Pelosi Heath Insurance Reform Bill that was recently passed by Congress and signed by the President, sometimes referred to as "ObamaCare".

And, we have the HHS Secretary being reported as saying this:
“There’s no question, right now, health care is being decided by insurance companies,” said Sebelius. “Part of the Affordable Care Act is to make sure that the tools are back in the hands of health care providers and patients to make their own decisions and so I think his leadership at this time is going to be critical.”
Taking decisions out of the hands of insurance companies and putting those decisions in the hands of health care providers and patients sounds good to me.

However, Dr Berwick talks about not fully resourcing our health care system, so we can find where the bottlenecks are.
“You cap your health care budget, and you make the political and economic choices you need to make to keep affordability within reach,” Berwick said. “You plan the supply; you aim a bit low; you prefer slightly too little of a technology or a service to too much; then you search for care bottlenecks and try to relieve them.”
That doesn't sound like putting things in the hands of the physicians and patients.  It sounds like putting things in the hands of the accountants.  As usual, I come down on the side of those who believe the Government is not capable to setting prices efficiently for a whole economy. 

The blog I originally went to noted that this approach of rationing to find the proper equilibrium in the medical market, provides this kind of situation:
Britain's higher cancer mortality rate results in 25,000 more cancer deaths per year compared to a similar population size in the United States.  But because the U.S. population is roughly five times larger than the United Kingdom's, that would translate into 125,000 unnecessary American cancer deaths every year.  This is more than all the mothers and fathers, aunts and uncles, cousins and children in Topeka, Kan.  And keep in mind, these numbers are for cancer alone. America also has better survival rates for other major killers, such as heart attacks and strokes.
I will agree with Dr Berwick that we need reasonably equal health care all.  We have too many people who are not getting reasonable care.  Part of that is due to a shortage of medical providers, something the new Health Insurance Reform is not going to fix.  But, are we really saying that Senator Edward Kennedy should not have been allowed to use his wealth to get the absolute best care he could afford?

Regards  —  Cliff

  And rationing of any kind leads to a growing black market.  The black market, in turn, can lead to financial and then political chaos.


ncrossland said...

Berwick is another Harvard intelligensia who is out to socialize the world through an expanded and empowered central government. He is not that far removed philosophically from establishing disposal stations through which, based on a physical health profile, one must report for termination, ala, 1984. If you get certain diseases or conditions, you become "unsalvagable" and must therefore be eliminated within a cost effective time period.

Presently, it will be through a ratcheted back level of care that you are "authorized" by the CMS. Since the few remaining physicians who will accept Medicare patients don't operate pro bono, they will be forced to adhere to approved treatment guidelines, which will be palliative for those with chronic, acute "life long" cancer, ALS, kidney failure, liver disease.

Recently in England, a 54 year old woman was diagnosed with a metastasized ovarian cancer, and was told by her NHS physician to go home and get her affairs in order, and that they would provide her with "necessary pain reducers" as her disease moved on toward death.

Well......HELL......she is going to die why waste the money. Right??? But then, if you concur with that line of reasoning.....we are all going to die of something, some day. So....lets get ahead of the cost curve and do some "weeding out" early. With genetic screeing, we can determine who will likely get what, and we can eliminate the problem before it becomes one.

George Orwell will be so proud.

I can't wait until all the loony liberals who clamored for "free" health care and death to the wicked private insurers and greedy physicians....wake up and find that THEIR health care consists of little more than occasional band-aid treatments.....unless you work for the Federal government.....

Jack Mitchell said...

This may be your "opinion", but it is horse puckey!

If you get certain diseases or conditions, you become "unsalvagable" and must therefore be eliminated within a cost effective time period.

As someone that subsists off of tax dollars, you got a lot of gall! I guess, to be fair, Blackwater didn't exist when you took your oath, but there was the Legion. Oops, more Socialists.

This puke about "death panels," no matter how shaded in vaguery, is GARBAGE!

When you denounce the dole, I'll by you a bullhorn. Otherwise, stand at parade rest.

JoeS said...

In using mortality rates it is important to distinguish between deaths per 100,000 population per year and 5-year survival rates. The former is a measure of success of the combination of lifestyle, genetics and the health care system. The latter may be a measure of how early in the life cycle of a disease that a problem is identified.

I would expect the factor of 5 cited for UK vs. US is based on 5-yr survival rates. Finding out early is not so great if the outcome is inevitable.

ncrossland said...

Lets be perfectly clear about one thing Jack......I don't "subsist" off of tax dollars nor am I on "the dole" as you imply. Your accusations are horse pucky. The dole is defined as: In the UK, Unemployment Benefit has been known by the slang term 'the dole' since WWI. This derives from the 'doling out', i.e. 'handing out' of charitable gifts of food or money. This dates back to at least 1919, when it was recorded in The Daily Mail:

"You won't draw your out-of-work dole of 29s. this week."

I can assure you that I am not the recipient of charitable gifts of food or money. I paid for my promised retirement...worked damned hard for it....and don't you EVER denigrate my service to this are a supercillious cad.

And I never mentioned death panels...You did. What is mentioned in a great many ways in the legislation is the "rationing" of health care. Of course, you are a non-believer having consumed the Obama Koolaid. Time will tell however.

Jack Mitchell said...

I scoff at you biting the hand the feeds you, not how you came about the hand out.

The phrase is "All gave some. Some gave all." There is no mention of just compenstation for services rendered.

H/T to you. You got one hell of a collective bargaining agreement. Next time I'm advocating for better veterans benefits, as we tax and spend liberals so often do, I'll remember to ignore your contempt.

PS. Retired military should refrain from "koolaid" lectures.

ncrossland said...

Jack, you are beneath my most vehement contempt.....and what restraint I can possibly muster prevents me from telling you what an insufferable, self righteous little worm I think you really are.....

Please don't advocate for those of us who served a lifetime......your "sacrifice" makes me violently ill.

tim said...

I must say, I do appreciate ncrossland's knack for understatement. It's really quite refreshing, compared to some of the over-the top rhetoric found on the internets.

C R Krieger said...

Well, I am trying to steer clear of part of this discussion, but as to the comment from JoeS, I must say that it is all a little confusing to those of us who try to understand what the numbers mean.

I was able to borrow from my Daughter two books on this kind of thing this week and will be looking at them for some insight, but I am afraid it is only going to be more confusing.  A quick glance showed that it was a lot of formulas and little prose.  And a certain amount of arbitrary decision making in doing the tables.

The comment "Finding out early is not so great if the outcome is inevitable." reminds me that not every society sees this the same way.  I remember from about ten years ago that there was some chap in Japan who sued the physician because the physician kept back the fact that his wife had cancer and was dying.  At the end of the day the Japanese Supreme Court ruled for the physician, saying that he protected the wife from embarrassment.  I am not sure dying in the dark is such a good thing either.

Regards  —  Cliff