Health Care in the nitty gritty

The ongoing debate over what to do about health care, health care costs, plans, choice, all the ingredients in the ongoing mess that is health care can all be seen in a nice bit of reporting by one of our local reporters. This article examines a local hospital and its dispute with one of the largest insurance companies, Anthem. When I read the article, I get the distinct feeling that everyone is angling here for more money using all the usual words, fairness, etc, but patient care is completely lost. An interesting short sighted solution has apparently lead to this problem: in an attempt to reduce medical costs, more and more services are moved away from the four walls of the hospital (because costs are higher there). But that move reduces the revenue stream of the hospital, so the hospital reaches out to the off campus sites, incorporates them into the hospital (through accounting categories) and then can bill at the higher rate. So, a cost savings measure leads to an unsustainble economy for the hospital which in turn plays accounting games to raise costs.

In the local case, the hospital cites the possible loss of three medical oncology pratices. I don't know if that means all medical oncology would be absent in Terre Haute. Perhaps three practices are not sustainable in this area, I don't know.

But this article, I think, lays out the real issues better than do the big stories, becuase this brings it home.

My daughter is currently at a language institute in Fes, Morocco. This is a video of her house in the Old Medina.




The house is 300 years old. Pretty cool, if I do say so myself.

Ahh, need I say (write) more?

Goofy thinking on opposing the public option in health care

Reforming our health care (non) system is needed. What reforms are needed, well, that is up for debate. To listen to the AMA it seems all that is needed is to end malpractice suits and pay docs exorbitant fees.

Hmm, I wish someone would show what docs made before medicare and after. I bet things got lots better for them.

Okay, there is lots of political propaganda out there and not much substance. But, one line of reasoning I don't quite follow. the public option is feared by those who oppose virtually any change at all because ??? they fear people will choose it? I mean, if a single payer system, if universal health care is SOOOOOOOOOOOOOOOOOOOOOOOOOOOOO bad, why fear a market choice? I mean, virtually anything that is "public" is deemed bad....public pools, the library, public schools, public land, everything. private, private, private....that is what America likes, so what is to fear?

Or, is it that in the marketplace of ideas, a simple system, wins out.

Use Civil Action to Curb Those Who Incite Violence

Previously published in the Terre Haute Tribune Star, 6/7/09

I am sick of reading statements like this: “There is no defense, no excuse that justifies the murder [last] Sunday of George Tiller, the Wichita, Kan., doctor who was one of the few physicians left in American who specialized in late-term abortions.” Yes there are excuses, far too many of them. All one has to do is read the many blogs, community forums, and talkback features on news sites. There is no shortage of excuses for the assassination of Dr. Tiller.

Those who make their living in the mainstream of US media still bend to social convention where it is “wrong” to endorse obvious murder. Outside the mainstream there are those who endorse his murder.

There is no shortage of opportunists jumping on this in order to advance their own agendas. Some are calling for curbs on incendiary and hate filled speech. I have no doubt that the incendiary and hate filled rhetoric creates a climate and is a contributing factor in Dr Tiller’s murder. It is the same rhetoric that Randall Terry, founder of Operation Rescue, refers to in his response to the assassination: “the pro-life movement must not be browbeaten by Obama or the child-killers into surrendering our best rhetoric, actions and images“. Mr. Terry is making excuses. The assassin, Mr. Roeder, appears to be linked to Operation Rescue.

How can talking heads, bloggers, and pundits condemn the incendiary speech of Islamic clerics as contributing to terrorism, such as:

“Terrorise [sic] your enemies as we cannot remain silent at their violations.
Otherwise, we will reach a stage when the consequences will be serious... I
am concerned about you because demonstrations are useless... Your enemy
loves terrorism and scorns nations and all Arabs. It seeks to silence the opinions of
others. I appeal to you not to resort to demonstrations because they
have become useless. You should resort to other methods. Moqtada al Sadr,
5 April 2004.

but not see the link between the rhetoric of leaders like Mr. Terry, or the statement by Dan Holman of Missionaries to the Preborn Iowa that he was “cheered” to hear about Dr. Tiller’s assassination. His response to whether he supported the killing: “I don’t advocate it, I don’t support it. But I don’t condemn it, and I believe that what he did was justifiable.” If it was justifiable then why would he not support the act? Mr. Holman continues that he supports the death of all abortionists and others including “George Bush, Barack Obama. Any politician that gives our tax money to Planned Parenthood and organizations that kill babies are participating in the killing of innocent children deserve the same penalty.” If that isn’t a clarion call for political assassination, then what is it?

There are those who deny that the rhetoric is any way connected to the actions. If so, then neither are motivational speeches related to actions. That is what this incendiary rhetoric is, motivational speech, and motivational speech should never be curbed or its content regulated. That’s why I disagree with calls by some on the left for laws to curb the incendiary speech of some in the pro-life movement. I do support, however, working within the current system. Just as the Klan was eventually defunded and rendered virtually inert (the organization but not white supremacist ideology), organizations like Mr. Holman’s, Operation Rescue, and other extremist organizations that suggest the political assassination of people they disagree with, should be carefully watched, though not necessarily by the government. I think a strategy like the Southern Poverty Law Center’s Klanwatch is what is needed to counter those who incite political violence against anyone who supports abortion rights. Bring suits to the civil courts with evidence that the extreme pro-life groups incite violence and conspire to commit violence and hit them in their pocket books. Those who motivate others to assassinate political opponents should be held accountable and the civil courts are a good place to do that.

Lynching was not “simple justice.” It was political violence. The political violence directed toward women, physicians, politicians, and those who support the right to choose is wrong. The civil and oft times heated debate about abortion, however, is welcomed. There is nothing wrong with trying to change people’s minds. Resorting to violence or motivating violence in the face of failure to convince one’s opponents is wrong and those who do so must be held accountable in our courts of law.

Flip Flop or now you get it

President Obama is set to flip flip on his campaign promise not to tax health benefits. See article here. I preferred McCain's general approach to health care reform. I think we need to sever the dependency of people on their employer for health care. Everything points to a more tumultuous relationship with employers, meaning, we are going to have more and more of them. The long term employment with a single employer, is going to get rarer and rarer. Many people remain at employers they don't like just for the health benefits. that is not good for the employee or for the employer (or perhaps it will cause the employer to change its ways).

So, President Obama will get nailed because he flip flopped on his campaign promises, but in this case, I think the willingness to tax health benefits, as much as that is going to sting (I'm one with good benefits and will pay more for them), is a good idea----if it actually delivers on what is promised.

The suggestions to water it down, only on e high end workers or only on the most generous health plans, nope, no good. Low income workers will still be low end and will miss much of the tax hit anyway, and, if there are caps put on and etc, employers will just find ways to get around them by rearranging benefits, etc. Make it simple, the money employers pay to employees for health care gets taxed...period.

Let's get it on with it.

Preventive Detention, preventing reelection

I was not and continue to not be an Obamamanic. I was, early on, a Hillary Clinton supporter but became increasingly disappointed in her campaign. I admit I did not think that the US was ready for a black president, but I also did not realize, early on, what a magnificent politician candidate Obama was. By the Indiana primary, after many long minutes in the ballot box, I voted for Obama because he ran a campaign like I thought one should be run, like a social movement.

I voted for him for president.

I did not, however, believe he was the super liberal, leftist, that many of his most ardent supporters did. I think many people projected their own views on him. He was especially skilled at getting people to do that.

So, that he has moved slower on Gitmo than many would like (me too). that he has backed off a little on Iraq withdrawal, that he has gone into Afghanistan (I agree wholeheartedly with that one), that he has not been bold in the specifics of his programs, though bold in scope, well, all that fits what I saw.

I also am not a single issue voter. So far, President Obama has been what I figured he would be. He is still a politician, he take a long view, and he tries to change the terms of debates. All intellectual stuff that I appreciate.

But, BUt, BUT, BUt, BUt......the May 20th NYT article on President Obama's talk on "preventive detention" sickens me. Article is here.

They [anonymous sources] said Mr. Obama told them he was thinking about “the
long game” — how to establish a legal system that would endure for future
presidents. He raised the issue of preventive detention himself, but made clear
that he had not made a decision on it. Several senior White House officials did
not respond to requests for comment on the outsiders’ accounts.

This really concerns me. What I am hoping all this was, was President Obama being the law professor who posed all kinds of arguments as just an exercise. To see how people responded, to hear arguments for and against. I sure hope so.

If President Obama moves forward in trying to establish some kind of preventive detention, which seems to completely turn our legal and political values on their head, I will be a single issue voter because to undermine due process as we understand it, is far worse than just about anything else the defender of our constitution is supposed to do.

What would pose as a threat? Providing material aid and comfort to terrorists? How about recognizing the legitimate politcal goals but denouncing the means? Would that be worthy of preventive detention? The very idea of this is frightening and I don't frighten easy.

Torture which has happened, repeatedly, and we (the public) don't care, the resistance in Congress to closing Gitmo (I'm not a Lyndsey Graham fan, but I agree with him completely on his position regarding Gitmo), I wonder who is going to resist preventive detention.

The terrorists win if we institute a legal shibboleth to begin preventive detention. Maybe they already have if we are seriously speaking about it.