The President has been misleading the people of America as he has discussed his health care take over plans.
On 14 April 2009 President Obama was interviewed about medical care and economic reforms. During the course of the interview he waxed philosophical and questioned whether or not his grandmother - or any other terminally or CHRONICALLY ill person - should receive quality of life care, such as hip replacement surgery.
Here's an article from Bloomberg.com from 29 April 2009.
Obama Says Grandmother’s Hip Replacement Raises Cost Questions
By Hans Nichols
April 29 (Bloomberg) -- President Barack Obama said his grandmother’s hip-replacement surgery during the final weeks of her life made him wonder whether expensive procedures for the terminally ill reflect a “sustainable model” for health care.
The president’s grandmother, Madelyn Dunham, had a hip replaced after she was diagnosed with cancer, Obama said in an interview with the New York Times magazine that was published today.
Dunham, who lived in Honolulu, died at the age of 86 on Nov. 2, 2008, two days
before her grandson’s election victory.
“I don’t know how much that hip replacement cost,” Obama said in the interview. “I would have paid out of pocket for that hip replacement just because she’s my grandmother.”
Obama said “you just get into some very difficult moral issues” when considering whether “to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill.
“That’s where I think you just get into some very difficult moral issues,” he said in the April 14 interview. “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health- care bill out here.”
Obama promised during his presidential campaign that a health-care overhaul would be a top priority, and he said at a Missouri town hall meeting today that he hopes Congress will pass health-care legislation this year.
The issue has been divisive, and finding an answer that will keep costs down while extending coverage to the estimated 46 million Americans without health insurance has eluded past presidents.
‘Ruthless Pragmatism’
Obama also said his economic advisers aren’t constrained by ideology or connections to former Treasury Secretary Robert Rubin. “What I’ve been constantly searching for is a ruthless pragmatism when it comes to economic policy,” he said, in the interview.
Obama also pointed to Canada as an example of a country that has effectively regulated commercial and investment banking without requiring legal separation of those activities.
“When it comes to something like investment banking versus commercial
banking, the experience in a country like Canada would indicate that good,
strong regulation that focuses less on the legal form of the institution and
more on the functions that they’re carrying out is probably the right approach
to take,” he said.
To contact the reporter on this story: Hans
Nichols in Washington at hnichols2@bloomberg.net
12 August 2009
Obama "Pragmatic" On Medical Decisions
Posted by The LS Voice at 9:27 AM
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2 comments:
John,
It's good to see that you're alive and well (and looking for a rhetorical boxing match!). Like you, I'm not one to miss an opportunity to bloviate. So here goes . . .
It's natural to feel uneasy when Obama muses about the sustainability of high spending on the elderly in their last years. There are countless medical options to help us as our bodies start to fall apart, and it seems like a shame to not provide a person with the best medical advances to extend his life and help him feel better.
And yet most new medical advances come at a price premium. Innovation in health care is usually a matter of increasing the medical effectiveness, not lowering prices. This is one of many factors making the trend of healthcare expenditures as a % of GDP simply untenable. [Other factors, like the separation of the consumer from the full cost, are arguably more important contributors.]
Would you agree that a perpetuation of the status quo is unacceptable? If not, then we would have a lot of ground to cover before we could continue this line of discussion. For the moment I'll assume that you would agree.
So back to Obama. Without wanting to defend Obama's overall vision for healthcare reform, I am sympathetic to his attempt to get us to think realistically about the healthcare system.
If we apply the 80/20 rule to healthcare, we immediately see that most health care expenditures (the "80"%) occur in the last couple years (the "20"%). It would be inappropriate not to frame the question Obama does. Notice that Obama only poses the question in the quote, noting that it raises "difficult moral issues". Although there are few ideas as hackneyed as starting a national "dialogue", since we're a democracy it makes perfect sense for us to start talking (or blogging). No doubt there are scary scenarios (infamous "death panels") that we wouldn't want to embrace.
The reality that Obama confronts is a projected Medicare problem that makes Social Security's insolvency look managable by comparison. But as Bismarck once noted, "Politics is the art of the possible." Whatever Obama eventually accomplishes in healthcare, you can be sure that it will leave everyone enough to dislike. A problem of this magnitude, of this complexity, with entrenched interests as diverse as the AARP, AMA, healthcare industry, surely will receive a suboptimal solution. There is enough self-interested (both good and perverted) to make sure that any policy is suboptimized.
The fact is that a type of health-care rationing already is taking place in the lowest rungs of society. Medicare and Medicaid help immensely, but inequities persist. I am personally open to the idea of better optimizing our health care spending. I don't know what a good solution would be at this point, but I'm sure we could help more lives if we were to sit back and reconsider the options. If we think of ourselves not just as citizens of the U.S., but also as citizens of the world, then we might ask whether diverting more of the dollars that would have been spent on domestic healthcare into international healthcare (e.g., Africa) couldn't have huge benefits.
How much healthcare could have been delivered to how many people in Africa for the cost of grandma's $80K surgery a couple months before she died? Is it wrong to ask the question and entertain other possibilities? What is at stake is important enough that it should be able to withstand scrutiny, analysis, discussion.
If we could agree on what should be maximized (a big IF), then we could design a policy that better optimized it. As bloodless as it may seem to talk about some equivalent for NPV (say, # of healthy years lived), if such a goal were in line with our values, such a yardstick could help us make trade-offs. And politics is nothing if not a steady stream of trade-offs. Our current system does not allow equal access and that is a concern.
I'd love to hear your views! [Gloves off]
Jared Sorensen
All healthcare systems "ration" care. Rationality makes us consider the value of a human life and most rational people would find that there is no economic value added by a person continuing to live beyond a certain time.
Of course, one must agree that there is no higher purpose to this life and no value in simply being human.
If we look at things economically, no medical care should be offered to those born with defects. No children should be cared for if they may not be expected to live to adulthood or will not be able to make a financial contribution to society. Only when a person is able to contribute taxes should we act to prolong their life. When illness or age has deteriorated a person's ability to produce more than he or she consumes, we should deny medical care and encourage them to die.
MOST Americans would find this unacceptable.
I posit that the premise of the United States of America, at its founding, was one of opportunity, not guarantees.
This country was established so that all people who come here can throw off governments and systems that kept them from achieving, and enjoy the fruits of their own labor.
Another fundamental tenet is that human life has inherent value. Further, human life is endowed with unalienable rights by its Creator. Those rights include life, liberty and the pursuit of happiness.
So, if life is an unalienable right, why should healthcare not be unalienable, also? We all need medical care at some time. In the United States all people have access to healthcare! They may not be able to afford it, but all people have the opportunity to buy it. The indigent are cared for gratis because it is against the law to deny medical care to any person based on their inability to pay.
Will a bum receive the same treatment that Ted Kennedy did, ceteris paribus? No. That addresses the question of inequity. It exists. But is the answer to give everyone the same level of mediocre medical care? No. We must elevate the level of care for the poorest among us, not bring everyone to the mean. Funding that can be done by solving the problems of the current system we have. "Average" is not acceptable.
Let's find the root of the problem. High cost and inequity are only symptoms.
The causes are many. I'll addresss few.
An atmosphere of litigation pervades healthcare. We need tort reform so those injured by negligent physicians or companies can be compensated, but frivolous lawsuits are stopped. This will stop "defensive medicine".
Any frivolous lawsuit should result in the court costs, attorney fees, expert witness fees, and all other fees being paid by the plaintif's attorney.
The burden placed on the healthcare system by illegals is enormous. Many cannot or do not pay their bills. Those costs pass to paying customers in higher costs.
Access to medical care must be restricted to legal residents and others who can show proof of ability to pay. We are not the universal tit for the world to suckle at. This is a land of laws; we must not accept those who would circumvent those laws.
Insurance regulation makes it impossible to access markets in all 50 states. This means that a company that has to pay corporate salaries and overhead in Ohio cannot leverage those expenses to cover the other 49 states.
Open up the insurance market. Let a healthcare provider evolve to offer low cost coverage to low risk customers. Let others fill the niche of high risk customers.
Government efficiency is a myth.
Lastly, the purpose of government is to provide opportunity and then get out of the way. I don't need them any deeper in my pocket than they are. I don't need them any further into my living room than they are. And I don't need them making more decisions about my life than they already do.
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