tag:blogger.com,1999:blog-12478084.post5938591148389767393..comments2024-01-17T02:39:06.048-05:00Comments on rude truth: Betsy McCaughey on the Daily ShowJJThttp://www.blogger.com/profile/14920416765778868736noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-12478084.post-70997140576271839382009-08-24T16:36:15.638-05:002009-08-24T16:36:15.638-05:00Jen,
Check out this article from the Atlantic. I...Jen, <br /><br />Check out this article from the Atlantic. It's a constructive and critical analysis of the healthcare reform debate. He's also a Democrat. http://www.theatlantic.com/doc/200909/health-care<br /><br />KarenAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-12478084.post-38634322738469748652009-08-24T01:15:22.940-05:002009-08-24T01:15:22.940-05:00I just don't know how to respond, Karen, becau...I just don't know how to respond, Karen, because I am too aware of my ignorance with regard to economic generally. There's just a lot in what you've said that I don't know what I need to know in order to put it together logically, or, possibly, I just have some large-scale presumptions that run counter to yours that are interfering, but either way, I can't for the life of me figure out how to respond with anything substantial. Sorry. Comment FAIL. :(JJThttps://www.blogger.com/profile/14920416765778868736noreply@blogger.comtag:blogger.com,1999:blog-12478084.post-33739879174340698802009-08-22T16:07:07.110-05:002009-08-22T16:07:07.110-05:00There are three ways to implement a universal heal...There are three ways to implement a universal healthcare system. A single-payer like Medicare which is going broke and fiscally unsustainable. Or a fee schedule like Tricare (military plan) that pays doctors less, so they have to see more patients. This impacts the quality of care and discourages people from entering an already shrinking field of primary care drs. The other is rationing. At some point, under a gov't run plan they will say,"You are too X or Y to receive more care." They are doing this in the Netherlands and have for years. <br /><br />We could not have the same care under the profit-driven system we have now under a universal plan. If we did, we'd go bankrupt. It's not just healthcare. That's another thing the Dems are missing. We would have to change how we train doctors. Where docs live. The number of hospitals available. There is no bill that will get out of Congress that's not rubber stamped by the pharmaceutical and insurance industry. Heck, the House bill is an health insurance company bailout. Even Obama knows that those industries support others. We don't have one economy, but economies within economies. Countries like Great Britain, Germany, Canada or Japan could have effective healthcare, if managed correctly, but they can't get it right. The US problem is much more challenging, because of the large volume of data. We'd have to have some form of virtual medical records to sustain a program like the House is proposing, but the technology doesn't exist to manage that data. The VA and DOD can't manage to create compatibility with their current digital record systems. And there aren't enough redundancies to access and store patient records if they are compromised. Just storing and maintaining records would incur a huge cost. <br /><br />People are hesitant about adding another 1 trillion to the taxpayer burden. Plus, there's little discussion about important issues like tort reform, incentivising docs to move to high demand locales, closing hospitals to reduce overhead, reforming Medicare and Medicaid and add more eligible recipients. A healthcare bill will pass, but Dems have tunnel vision in this healthcare reform debate, and it will be a mess.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12478084.post-38579647147056976782009-08-22T12:24:49.279-05:002009-08-22T12:24:49.279-05:00Maybe living wills are irrelevant for people who d...Maybe living wills are irrelevant for people who don't think about their mortality until it's inevitable. I think that's a bit unwise, but there's nothing anyone can do to force someone to be introspective about their mortality; all you can do is suggest that maybe that's a good idea. And that seems to be the point of "Health Care Decisions Day" up in Alaska, and the point (as I interpret it) of this section of the HR 3200 bill.<br /><br />I do think it's a valid concern generally to make sure that advance directives and living wills actually do reflect the individual's own wishes. I don't know about the VA document, other than what the article you linked to says about it, but if it does in fact push people one way or another, then that is problematic. I would find it equally problematic regardless of which agenda is being covertly pushed. The "Five Wishes" document referenced in the article I have some passing familiarity with, having acquired a copy awhile back at an adult Bible class in church discussing issues of a biomedical nature.<br /><br />But the question is whether HR 3200, section 1233 has the same problems as the VA document Towey refers to, and I don't see that it does. I don't think it's disingenuous to raise the issue of how important it is to make sure that people are able to express their own wishes regarding end-of-life care, but I do think it's disingenuous to insist, like McCaughey does, that <i>this bill</i> pushes an agenda to withhold or withdraw care.<br /><br />I had heard that this section has been thrown out, but McCaughey was still making this a central point of her case that this bill is "dangerous for seniors." So it's still being used as a talking point, even if it's totally irrelevant in terms of the process. Maybe she should be talking about how the VA document is "dangerous for veterans" instead, if Towey's take on the document is accurate, but it seems to me that's another discussion.<br /><br />I'm not quite getting, though, what you're arguing in the first paragraph: "Under a universal health plan, extending life as long as the patient desires will compete with efforts to manage healthcare costs. That means rationing to some extent." I get that in a general sense if everyone chose end-of-life care that included all possible medical interventions, that this would mean incurring the costs of these life-sustaining procedures. How does that connect to rationing? Is it that these priorities (life-extension versus cost-cutting) are necessarily competing, so that if cutting costs is a priority then you have to therefore push withdrawal of end-of-life care? If I'm reading this right, then it seems that the argument is "fiscal responsibility" must always conflict with life-extension, which certainly flies in the face of the general right/conservative/Republican position on these two things. And personally I'm not willing to grant that these priorities have to be in conflict.JJThttps://www.blogger.com/profile/14920416765778868736noreply@blogger.comtag:blogger.com,1999:blog-12478084.post-69893005860066202782009-08-22T00:39:02.873-05:002009-08-22T00:39:02.873-05:00"paring knife" - It's too late."paring knife" - It's too late.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12478084.post-39192564296650966512009-08-22T00:20:10.318-05:002009-08-22T00:20:10.318-05:00I don't think her argument is about greedy doc...I don't think her argument is about greedy docs or politicians who want to kill you. It is about priorities. Under a universal health plan, extending life as long as the patient desires will compete with efforts to manage healthcare costs. That means rationing to some extent. That's not necessarily bad if you consider that healthcare is currently profit driven - people are give more tests than they need. I'm not saying there doesn't need to be reform, but I'm really tired of the Left skewering anyone who dares to raise concerns about the House's 1000 page juggernaut. <br /><br />You should read Charles Krauthammer's latest piece cutting through all the "death panel" hyperbole. In it, he discusses that living wills are really irrelevant for most people, because you really don't know what you want until you're facing death. I think the design of this aspect of the bill is to consider quality of life and quantity. If you have could have 1 year left on a morphine drip or two years throwing up and weak from chemo, which would you choose?But do you want a bureaucrat putting his two cents in along with counseling from your doctor? Fact is, hospice and palliative care is cheaper than chemo/radiation trials and surgeries. But the House uses a sledgehammer, instead of pairing knife to explain this.<br /><br />However, the "Trojan Horse" theory is not entirely without merit. Consider the recent reactivation of "Your Life, Your Choices" over at the VA. This is great example of bureaucrats trying to justify their jobs through confusing mandates. http://online.wsj.com/article/SB10001424052970204683204574358590107981718.html. If you want some idea of how gov't may manage healthcare under a universal health system, read up on the VA. It ain't pretty. <br /><br />But I'm a little confused as to why this is relevant considering, I believe, the Senate threw out end-of-life counseling provisions in committee. What should be more concerning is the deals the Obama administration is brokering with the pharmaceutical lobby. Even Air America is on that.<br /><br />Regards,<br /><br />KarenAnonymousnoreply@blogger.com