Government Universal Health Care, from Ezekiel Emanuel

[alan1]

RealClearPolitics - The Attack On Doctors' Hippocratic Oath

The Attack On Doctors' Hippocratic Oath
By Betsy McCaughey

Patients count on their doctor to do whatever is possible to treat their illness. That is the promise doctors make by taking the Hippocratic Oath.

But President Obama's advisers are looking to save money by interfering with that oath and controlling your doctor's decisions.

Ezekiel Emanuel sees the Hippocratic Oath as one factor driving "overuse" of medical care. He is a policy adviser in the Office of Management and Budget (OMB) and a brother of Rahm Emanuel, the president's chief of staff.

Dr. Emanuel argues that "peer recognition goes to the most thorough and aggressive physicians." He has lamented that doctors regard the "Hippocratic Oath's admonition to 'use my power to help the patient to the best of my ability and judgment' as an imperative to do everything for the patient regardless of the cost or effects on others."

Of course, that is what patients hope their doctor will do.

But President Barack Obama is pledging to rein in the nation's health care spending. The framework for influencing your doctor's decisions was included in the stimulus package, also known as the American Recovery and Reinvestment Act of 2009.

The legislation sets a goal that every individual's treatments will be recorded by computer, and your doctor will be guided by electronically delivered protocols on "appropriate" and "cost-effective" care.

Heading the new system is Dr. David Blumenthal, a Harvard Medical School professor, named national coordinator of health information technology. His writings show he favors limits on how much health care people can get.

"Government controls are a proven strategy for controlling health care expenditures," he argued in the New England Journal of Medicine (NEJM) in March 2001.

Blumenthal conceded there are disadvantages:

"Longer waits for elective procedures and reduced availability of new and expensive treatments and devices."

Yet he called it "debatable" whether the faster care Americans currently have is worth the higher cost.

Now that Blumenthal is in charge, he sees problems ahead.

"If electronic health records are to save money," he writes, doctors will have to take "advantage of embedded clinical decision support" (a euphemism for computers instructing doctors what to do).

"If requirements are set too high, many physicians and hospitals will rebel - petitioning Congress to change the law or just resigning themselves to ... accepting penalties," he wrote in NEJM early this month.

The public applauded the new requirement for electronic records, not foreseeing that it would put faceless bureaucrats in charge of your care.

How many of you want the government to determine your "appropriate and cost effective" health care?

 

[dilloduck]

RealClearPolitics - The Attack On Doctors' Hippocratic Oath

The Attack On Doctors' Hippocratic Oath
By Betsy McCaughey

Patients count on their doctor to do whatever is possible to treat their illness. That is the promise doctors make by taking the Hippocratic Oath.

But President Obama's advisers are looking to save money by interfering with that oath and controlling your doctor's decisions.

Ezekiel Emanuel sees the Hippocratic Oath as one factor driving "overuse" of medical care. He is a policy adviser in the Office of Management and Budget (OMB) and a brother of Rahm Emanuel, the president's chief of staff.

Dr. Emanuel argues that "peer recognition goes to the most thorough and aggressive physicians." He has lamented that doctors regard the "Hippocratic Oath's admonition to 'use my power to help the patient to the best of my ability and judgment' as an imperative to do everything for the patient regardless of the cost or effects on others."

Of course, that is what patients hope their doctor will do.

But President Barack Obama is pledging to rein in the nation's health care spending. The framework for influencing your doctor's decisions was included in the stimulus package, also known as the American Recovery and Reinvestment Act of 2009.

The legislation sets a goal that every individual's treatments will be recorded by computer, and your doctor will be guided by electronically delivered protocols on "appropriate" and "cost-effective" care.

Heading the new system is Dr. David Blumenthal, a Harvard Medical School professor, named national coordinator of health information technology. His writings show he favors limits on how much health care people can get.

"Government controls are a proven strategy for controlling health care expenditures," he argued in the New England Journal of Medicine (NEJM) in March 2001.

Blumenthal conceded there are disadvantages:

"Longer waits for elective procedures and reduced availability of new and expensive treatments and devices."

Yet he called it "debatable" whether the faster care Americans currently have is worth the higher cost.

Now that Blumenthal is in charge, he sees problems ahead.

"If electronic health records are to save money," he writes, doctors will have to take "advantage of embedded clinical decision support" (a euphemism for computers instructing doctors what to do).

"If requirements are set too high, many physicians and hospitals will rebel - petitioning Congress to change the law or just resigning themselves to ... accepting penalties," he wrote in NEJM early this month.

The public applauded the new requirement for electronic records, not foreseeing that it would put faceless bureaucrats in charge of your care.

How many of you want the government to determine your "appropriate and cost effective" health care?

hmm I'll pass

 

[Immanuel]

How many of you want the government to determine your "appropriate and cost effective" health care?

hmm I'll pass

Unfortunately, you might not be given the option to pass.

Immie

 

[alan1]

hmm I'll pass

Don't bet your bottom dollar on it.
You may be forced into it.

 

[dilloduck]

How many of you want the government to determine your "appropriate and cost effective" health care?

hmm I'll pass

Unfortunately, you might not be given the option to pass.

Immie

If Obomba is allowed to continue I don't think we will have ANY options.

 

[Immanuel]

hmm I'll pass

Unfortunately, you might not be given the option to pass.

Immie

If Obomba is allowed to continue I don't think we will have ANY options.

No, you are wrong, there will be an option... take it or suffer the consequences.

Immie

 

[alan1]

Unfortunately, you might not be given the option to pass.

Immie

If Obomba is allowed to continue I don't think we will have ANY options.

No, you are wrong, there will be an option... take it or suffer the consequences.

Immie

Don't you mean,
Take it and suffer the consequences?

 

[editec]

How many of you watned the beancounters in the private insurance companies to interfere with you and your doctors' decisions about your health care?

None of you right?

Only that's exactly what's going on right now, too.

This complaint about socialized medicines is entirely specious, folks, because what you fear from socialized medicine is ALREADY happening to you all with PRIVATE HC insurance, right now.

 

[Skull Pilot]

Personally, I am going to ask my doctor for a copy of my medical records. I would rather carry them around to different doctors than to trust the fingers of some fat assed sycophantic overpaid corrupt bureaucrat to enter my data correctly.

And is it the government's right to confiscate and keep personal and confidential medical records. Until now at least doctor patient confidentiality has been sacrosanct.

Where are all the Dimwit Dimocrats who railed against wire tapping of foreigners when the fucking government wants to control every American's most personal information???????

 

[Immanuel]

How many of you watned the beancounters in the private insurance companies to interfere with you and your doctors' decisions about your health care?

None of you right?

Only that's exactly what's going on right now, too.

This complaint about socialized medicines is entirely specious, folks, because what you fear from socialized medicine is ALREADY happening to you all with PRIVATE HC insurance, right now.

One difference... with Private Healthcare you get to pick the bean counters who make those decisions. In theory, this means that the bean counters have to compete for your business which would, in theory, mean that they have to be somewhat flexible and provide coverage for needed procedures or the company they work for goes down the tubes. In other words, if these bean counters won't cover my expenses, then I will go to another insurance company that will. Where as under Universal or National Healthcare, the bean counters collect their checks and take orders from the government and they don't have to provide you with Jack Shit.

Personally, I would chose the bean counters that rely on my dollars rather than the ones that rely on the government's dollars.

Immie

 

[editec]

How many of you watned the beancounters in the private insurance companies to interfere with you and your doctors' decisions about your health care?

None of you right?

Only that's exactly what's going on right now, too.

This complaint about socialized medicines is entirely specious, folks, because what you fear from socialized medicine is ALREADY happening to you all with PRIVATE HC insurance, right now.

One difference... with Private Healthcare you get to pick the bean counters who make those decisions. In theory, this means that the bean counters have to compete for your business which would, in theory, mean that they have to be somewhat flexible and provide coverage for needed procedures or the company they work for goes down the tubes. In other words, if these bean counters won't cover my expenses, then I will go to another insurance company that will. Where as under Universal or National Healthcare, the bean counters collect their checks and take orders from the government and they don't have to provide you with Jack Shit.

Personally, I would chose the bean counters that rely on my dollars rather than the ones that rely on the government's dollars.

Immie

That is a good point, Immie.

I am not really aware of how differently these insurance companies handle their claims, but I suspect they are more or less on the same wavelength.

Why?

Because if they were not, then those more generous insurance companies would be paying out wildly differently for their claims and the more generous ones would go broke.

You see, the less generous ones would do exactly what they did to Blue Cross and Blue Shield and cherrypick the less costly clients away from the more generous companies.

Thus, they be leaving those more generous private insurers with the more expensive clients whose claims would cut into their profits.

I suppose there must be minor differences, of course.

But I'm dubious (based on nothing more than the logic above) that they can be very different.

 

[alan1]

How many of you watned the beancounters in the private insurance companies to interfere with you and your doctors' decisions about your health care?

None of you right?

Only that's exactly what's going on right now, too.

This complaint about socialized medicines is entirely specious, folks, because what you fear from socialized medicine is ALREADY happening to you all with PRIVATE HC insurance, right now.

One difference... with Private Healthcare you get to pick the bean counters who make those decisions. In theory, this means that the bean counters have to compete for your business which would, in theory, mean that they have to be somewhat flexible and provide coverage for needed procedures or the company they work for goes down the tubes. In other words, if these bean counters won't cover my expenses, then I will go to another insurance company that will. Where as under Universal or National Healthcare, the bean counters collect their checks and take orders from the government and they don't have to provide you with Jack Shit.

Personally, I would chose the bean counters that rely on my dollars rather than the ones that rely on the government's dollars.

Immie

I disagree with a lot of your stances on politics, Immie, but that was well said.

 

[Immanuel]

That is a good point, Immie.

I am not really aware of how differently these insurance companies handle their claims, but I suspect they are more or less on the same wavelength.

Why?

Because if they were not, then those more generous insurance companies would be paying out wildly differently for their claims and the more generous ones would go broke.

You see, the less generous ones would do exactly what they did to Blue Cross and Blue Shield and cherrypick the less costly clients away from the more generous companies.

Thus, they be leaving those more generous private insurers with the more expensive clients whose claims would cut into their profits.

I suppose there must be minor differences, of course.

But I'm dubious (based on nothing more than the logic above) that they can be very different.

Here is an example I thought of in response to your post.

One of the arguments against "The Fair Tax", Americans For Fair Taxation: Americans For Fair Taxation is that if the government stops taxing corporations the corporations will not pay taxes and neither will they drop their prices. Well, that argument is really preposterous in a Capitalistic society. What will happen is that if corporate taxes are reduced or eliminated then the costs to the corporation are going to go down.

Why is Walmart so cheap? One big reason is that they have purchasing power. They can buy from their suppliers at costs significantly below the cost of their competition. Let's say they can buy widgets at a dollar each. They can mark it up say 40% and sell it for $1.40. If Pop's Widget Shop can only buy widget for $1.35, then to compete with Walmart they can only mark up each widget a nickel which most likely is not enough to cover overhead and Pop Widget Shop goes bankrupt. However, the companies that can compete with Walmart will compete.

If corporate taxes go down 20% then the price of widgets can drop to $1.12 and corporations will still make the same profit. How long do you think it will take before Walmart and Target drop their prices on Widgets to steal customers from other widget dealers? How long do you think it will take for the others to follow?

The same goes with Private Healthcare. If United Healthcare does not cover a new and promising Cancer treatment; but Kaiser, Aetna, Blue Cross/Blue Shield and any others do; and customers begin abandoning United because of the treatment, United will have to re-evaluate its policy very quickly or face extermination.

Put it in the government's bean counter's hands and that Cancer treatment may not be available to anyone at all.

Immie

 

[Care4all]

That is a good point, Immie.

I am not really aware of how differently these insurance companies handle their claims, but I suspect they are more or less on the same wavelength.

Why?

Because if they were not, then those more generous insurance companies would be paying out wildly differently for their claims and the more generous ones would go broke.

You see, the less generous ones would do exactly what they did to Blue Cross and Blue Shield and cherrypick the less costly clients away from the more generous companies.

Thus, they be leaving those more generous private insurers with the more expensive clients whose claims would cut into their profits.

I suppose there must be minor differences, of course.

But I'm dubious (based on nothing more than the logic above) that they can be very different.

Here is an example I thought of in response to your post.

One of the arguments against "The Fair Tax", Americans For Fair Taxation: Americans For Fair Taxation is that if the government stops taxing corporations the corporations will not pay taxes and neither will they drop their prices. Well, that argument is really preposterous in a Capitalistic society. What will happen is that if corporate taxes are reduced or eliminated then the costs to the corporation are going to go down.

Why is Walmart so cheap? One big reason is that they have purchasing power. They can buy from their suppliers at costs significantly below the cost of their competition. Let's say they can buy widgets at a dollar each. They can mark it up say 40% and sell it for $1.40. If Pop's Widget Shop can only buy widget for $1.35, then to compete with Walmart they can only mark up each widget a nickel which most likely is not enough to cover overhead and Pop Widget Shop goes bankrupt. However, the companies that can compete with Walmart will compete.

If corporate taxes go down 20% then the price of widgets can drop to $1.12 and corporations will still make the same profit. How long do you think it will take before Walmart and Target drop their prices on Widgets to steal customers from other widget dealers? How long do you think it will take for the others to follow?

The same goes with Private Healthcare. If United Healthcare does not cover a new and promising Cancer treatment; but Kaiser, Aetna, Blue Cross/Blue Shield and any others do; and customers begin abandoning United because of the treatment, United will have to re-evaluate its policy very quickly or face extermination.

Put it in the government's bean counter's hands and that Cancer treatment may not be available to anyone at all.

Immie

It does make sense but what is missing out othis equation is that most people take out their health Insurance with their employer and usually only one, 2 at the most, insurance company plans are offered for you to take and both from the same company...

There is no shopping around for the "better" policy available to us Immie...at least for the most part.

The person doing the shopping for all 100 employees of the company is the one doing the shopping and usually the cheapest policy possible is the end call on what company the corp or company decides to go with....

And also, there will be some employees that could want "these" benefits avail and others that want "those" benefits available...in other words, there will always be employees that do not have the plan of their own personal needs yet they are locked in to the health plan they are in, because it is the only one available to them, if they want the 50% to 80% that the Company usually contributes to the employee's plan.

They "system" is still screwed up and we are still "strapped" in our own individual health care needs...

HOWEVER, I still believe it is better than going in to a single payer Universal Health Care Plan, as you do....

Only, it sickens me to say such...because the 33% of our healthcare costs that goes simply to the people that push the paperwork, the Insurance companies is a disgrace and a pure waste of money....which could actually be used to physically get us medical care, or more costly procedures or technology or better benefits overall...you would think....?

Even if there is no single payer, universal plan instituted, our health care structure in this country in the private sector needs reform....costs going up double digits every single year is unsustainable, for the individual and for these companies offering health care as a benefit.

Care

 

[Immanuel]

That is a good point, Immie.

I am not really aware of how differently these insurance companies handle their claims, but I suspect they are more or less on the same wavelength.

Why?

Because if they were not, then those more generous insurance companies would be paying out wildly differently for their claims and the more generous ones would go broke.

You see, the less generous ones would do exactly what they did to Blue Cross and Blue Shield and cherrypick the less costly clients away from the more generous companies.

Thus, they be leaving those more generous private insurers with the more expensive clients whose claims would cut into their profits.

I suppose there must be minor differences, of course.

But I'm dubious (based on nothing more than the logic above) that they can be very different.

Here is an example I thought of in response to your post.

One of the arguments against "The Fair Tax", Americans For Fair Taxation: Americans For Fair Taxation is that if the government stops taxing corporations the corporations will not pay taxes and neither will they drop their prices. Well, that argument is really preposterous in a Capitalistic society. What will happen is that if corporate taxes are reduced or eliminated then the costs to the corporation are going to go down.

Why is Walmart so cheap? One big reason is that they have purchasing power. They can buy from their suppliers at costs significantly below the cost of their competition. Let's say they can buy widgets at a dollar each. They can mark it up say 40% and sell it for $1.40. If Pop's Widget Shop can only buy widget for $1.35, then to compete with Walmart they can only mark up each widget a nickel which most likely is not enough to cover overhead and Pop Widget Shop goes bankrupt. However, the companies that can compete with Walmart will compete.

If corporate taxes go down 20% then the price of widgets can drop to $1.12 and corporations will still make the same profit. How long do you think it will take before Walmart and Target drop their prices on Widgets to steal customers from other widget dealers? How long do you think it will take for the others to follow?

The same goes with Private Healthcare. If United Healthcare does not cover a new and promising Cancer treatment; but Kaiser, Aetna, Blue Cross/Blue Shield and any others do; and customers begin abandoning United because of the treatment, United will have to re-evaluate its policy very quickly or face extermination.

Put it in the government's bean counter's hands and that Cancer treatment may not be available to anyone at all.

Immie

It does make sense but what is missing out othis equation is that most people take out their health Insurance with their employer and usually only one, 2 at the most, insurance company plans are offered for you to take and both from the same company...

There is no shopping around for the "better" policy available to us Immie...at least for the most part.

The person doing the shopping for all 100 employees of the company is the one doing the shopping and usually the cheapest policy possible is the end call on what company the corp or company decides to go with....

And also, there will be some employees that could want "these" benefits avail and others that want "those" benefits available...in other words, there will always be employees that do not have the plan of their own personal needs yet they are locked in to the health plan they are in, because it is the only one available to them, if they want the 50% to 80% that the Company usually contributes to the employee's plan.

They "system" is still screwed up and we are still "strapped" in our own individual health care needs...

HOWEVER, I still believe it is better than going in to a single payer Universal Health Care Plan, as you do....

Only, it sickens me to say such...because the 33% of our healthcare costs that goes simply to the people that push the paperwork, the Insurance companies is a disgrace and a pure waste of money....which could actually be used to physically get us medical care, or more costly procedures or technology or better benefits overall...you would think....?

Even if there is no single payer, universal plan instituted, our health care structure in this country in the private sector needs reform....costs going up double digits every single year is unsustainable, for the individual and for these companies offering health care as a benefit.

Care

You are correct Care, but, in my experience the person who is "shopping around" for company provided healthcare is a) looking out for the good of the company and/or the best fit for employees, b) looking out for the best policy that fits their own needs. Hey, HR people can be selfish too!

Either way, they are looking out for the best for the employees not the best for the government. Regardless, the insurance companies do have to compete for our business and to compete they need to offer services that are more cost effective than what their competition offers. If they don't, they won't succeed.

You are ABSOLUTELY correct that our system needs reform. The only question is how best to go about that.

Immie

 

[alan1]

Here is an example I thought of in response to your post.

One of the arguments against "The Fair Tax", Americans For Fair Taxation: Americans For Fair Taxation is that if the government stops taxing corporations the corporations will not pay taxes and neither will they drop their prices. Well, that argument is really preposterous in a Capitalistic society. What will happen is that if corporate taxes are reduced or eliminated then the costs to the corporation are going to go down.

Why is Walmart so cheap? One big reason is that they have purchasing power. They can buy from their suppliers at costs significantly below the cost of their competition. Let's say they can buy widgets at a dollar each. They can mark it up say 40% and sell it for $1.40. If Pop's Widget Shop can only buy widget for $1.35, then to compete with Walmart they can only mark up each widget a nickel which most likely is not enough to cover overhead and Pop Widget Shop goes bankrupt. However, the companies that can compete with Walmart will compete.

If corporate taxes go down 20% then the price of widgets can drop to $1.12 and corporations will still make the same profit. How long do you think it will take before Walmart and Target drop their prices on Widgets to steal customers from other widget dealers? How long do you think it will take for the others to follow?

The same goes with Private Healthcare. If United Healthcare does not cover a new and promising Cancer treatment; but Kaiser, Aetna, Blue Cross/Blue Shield and any others do; and customers begin abandoning United because of the treatment, United will have to re-evaluate its policy very quickly or face extermination.

Put it in the government's bean counter's hands and that Cancer treatment may not be available to anyone at all.

Immie

It does make sense but what is missing out othis equation is that most people take out their health Insurance with their employer and usually only one, 2 at the most, insurance company plans are offered for you to take and both from the same company...

There is no shopping around for the "better" policy available to us Immie...at least for the most part.

The person doing the shopping for all 100 employees of the company is the one doing the shopping and usually the cheapest policy possible is the end call on what company the corp or company decides to go with....

And also, there will be some employees that could want "these" benefits avail and others that want "those" benefits available...in other words, there will always be employees that do not have the plan of their own personal needs yet they are locked in to the health plan they are in, because it is the only one available to them, if they want the 50% to 80% that the Company usually contributes to the employee's plan.

They "system" is still screwed up and we are still "strapped" in our own individual health care needs...

HOWEVER, I still believe it is better than going in to a single payer Universal Health Care Plan, as you do....

Only, it sickens me to say such...because the 33% of our healthcare costs that goes simply to the people that push the paperwork, the Insurance companies is a disgrace and a pure waste of money....which could actually be used to physically get us medical care, or more costly procedures or technology or better benefits overall...you would think....?

Even if there is no single payer, universal plan instituted, our health care structure in this country in the private sector needs reform....costs going up double digits every single year is unsustainable, for the individual and for these companies offering health care as a benefit.

Care

You are correct Care, but, in my experience the person who is "shopping around" for company provided healthcare is a) looking out for the good of the company and/or the best fit for employees, b) looking out for the best policy that fits their own needs. Hey, HR people can be selfish too!

Either way, they are looking out for the best for the employees not the best for the government. Regardless, the insurance companies do have to compete for our business and to compete they need to offer services that are more cost effective than what their competition offers. If they don't, they won't succeed.

You are ABSOLUTELY correct that our system needs reform. The only question is how best to go about that.

Immie

Inserting the government into the equation is not the answer.

 

[Immanuel]

. The only question is how best to go about that.

Immie

Inserting the government into the equation is not the answer.

My thoughts exactly.

Immie

 

[alan1]

. The only question is how best to go about that.

Immie

Inserting the government into the equation is not the answer.

My thoughts exactly.

Immie

Are you of the opinion that government has no reason, no business, no responsibility, no right, to get involved in health care?
I am.

 

[thinking]

Yeah, the current system is really flawed. I think maybe the government should pass some kind of law which requires everyone to basic health care isurance--sort of like the car insurance law. Because a big reason why costs are so high is many people simply don't pay for their medical care. There are alot of people who are to poor and have to use the emergency room for things like a bad cold--something which could be taken care of much more cost effectively with a doctor. But there are also alot of people who simply don't buy insurance. Their well off and decide to buy a boat instead of an expensive insurance policy, and then when something happens to them, they can't pay their medical bills and people who buy insurance instead of a boat foot the bill. Because hospitals will never refuse care, EVERYONE should have SOME kind of health insurance, so they are at least paying part of their bill.

 

[Immanuel]

Inserting the government into the equation is not the answer.

My thoughts exactly.

Immie

Are you of the opinion that government has no reason, no business, no responsibility, no right, to get involved in health care?
I am.

I am not sure I agree with that statement.

No Reason--the reason would be that the industry is out of whack. Medical Malpractice Insurance, Trial Lawyers, Prescription Drug costs and companies, the cost of schooling for doctors and other things have worked to push the cost of health care out of reach for people. The government might just be needed to bring these costs in control. How that can be accomplished, I'm not sure.

No Business--the government is there to fix problems that people cannot fix. This might be one of those cases. A permanent fixture in healthcare though? That could be a recipe for disaster.

No Responsibility--my answer to that goes along a lot with no business. The government has the responsibility to take care of issues that the people can't do by themselves. Maybe it is the government's responsibility to bring healthcare in line.

No right--we as a country give them the right, don't we?

However, the answer of giving our care up to a government bean counter is a scary thought. I'm a "bean counter". I know nothing about the medical field, but I know a lot about the need to cut costs and maximize revenue. So, when it comes to putting your life into a doctor's hands, or mine... who are you going to turn to?

Immie