Health Care Again

Charles Peters at The Washington Monthly identifies four ways health care reform can lead to less expensive, but better, health care:

• Give the government the power to negotiate prices with the drug companies. This could save Medicare a ton of money—the Veterans Administration cut its drug bill in half when given the right to negotiate. The House bill makes this reform, but the Los Angeles Times reported that the White House has made a deal with the drug companies’ chief lobbyist, Billy Tauzin, not to support the reform. According to the New York Times, the White House at first confirmed the deal, but then denied it—sort of. The potential savings of having the government bargain for drug prices are so great that Obama should leave no doubt. He should repudiate the deal. Better to betray Billy Tauzin than to betray the American people.

• Abolish or radically reduce drug advertising. Remember, it was outlawed until relatively recently—and for good reason. Not only does it often obscure dangerous side effects, it encourages people to bug doctors to prescribe drugs either that they don’t need or that are the most expensive of the possible therapies. Representative Jerrold Nadler has offered a bill to take away the tax exemption that is now given to drug advertising. And the FDA is proposing regulations that would require drug ads to disclose side effects in an obvious way instead of rapidly reciting them sotto voce over sunny pictures of people happily enjoying the benefits of the drug.

• Encourage doctors to work in Mayo- and Cleveland-type clinics that have doctors working together, and that pay salaries instead of fees for service. Massachusetts, the only state with experience offering near-universal health care, is now being urged by a high-level commission to abolish fee for service, which encourages physicians to recommend services that pay the highest fee, rather than those that are the most needed by the patient.

• Don’t allow physicians to administer expensive tests in their own offices when that encourages them to order more tests than they ordinarily would. To understand why, consider this anecdote reported by the Washington Post’s Shankar Vedantam: "In August 2005, doctors at Urological Associates, a medical practice on the Iowa-Illinois border, ordered nine CT scans for patients covered by Wellmark Blue Cross and Blue Shield insurance. In September that year, they ordered eight. But then the numbers rose steeply. The urologists ordered 35 scans in October, 41 in November and 55 in December. Within seven months they were ordering scans at a rate that had climbed more than 700 percent. The increase came in the months after the urologists bought their own CT scanner."

The practice of medicine is a different animal than it was in the old days.

All Health Insurance, All the Time

Andrew Tobias to the rescue, again. This morning he points us to this article by Matt Miller at The Daily Beast:

The truth is that everything that’s taking place right now is irrelevant.... Between now and [the House/Senate conference], everyone should take a deep breath. The talking heads have to fill up air time, but the rest of us should remember: until we get to conference, it's all prelude.

We need to think back to Obama's incredible political campaign. Does everybody remember a time when we were all frantic? We thought Obama was being too easy on McCain? He had dropped in the polls!

These guys know what they're doing.

Courage is not a common commodity among politicians. Right now they're being pummeled by the wackos. We need to take Matt Miller's advice: "Legislators need to get the message that their constituents want "change" on health care, and will punish them for supporting the status quo."

And the Republican Party needs to be put on notice that if health insurance reform fails to pass, they will be held accountable.

Health Insurance Reform

Steven Pearlstein, the business columnist for the Washington Post, is a must read today.

While holding themselves out as paragons of fiscal rectitude, Republicans grandstand against just about every idea to reduce the amount of health care people consume or the prices paid to health-care providers -- the only two ways I can think of to credibly bring health spending under control.

When Democrats, for example, propose to fund research to give doctors, patients and health plans better information on what works and what doesn't, Republicans sense a sinister plot to have the government decide what treatments you will get. By the same wacko-logic, a proposal that Medicare pay for counseling on end-of-life care is transformed into a secret plan for mass euthanasia of the elderly.

Government negotiation on drug prices? The end of medical innovation as we know it, according to the GOP's Dr. No. Reduce Medicare payments to overpriced specialists and inefficient hospitals? The first step on the slippery slope toward rationing.

Can there be anyone more two-faced than the Republican leaders who in one breath rail against the evils of government-run health care and in another propose a government-subsidized high-risk pool for people with chronic illness, government-subsidized community health centers for the uninsured, and opening up Medicare to people at age 55?

Health reform is a test of whether this country can function once again as a civil society -- whether we can trust ourselves to embrace the big, important changes that require everyone to give up something in order to make everyone better off. [My emphasis.] Republican leaders are eager to see us fail that test. We need to show them that no matter how many lies they tell or how many scare tactics they concoct, Americans will come together and get this done.

If health reform is to be anyone's Waterloo, let it be theirs.

Meanwhile, over at the NY Times, Paul Krugman is saying this:

... right now Mr. Obama’s backers seem to lack all conviction, perhaps because the prosaic reality of his administration isn’t living up to their dreams of transformation. Meanwhile, the angry right is filled with a passionate intensity.

And if Mr. Obama can’t recapture some of the passion of 2008, can’t inspire his supporters to stand up and be heard, health care reform may well fail.

That "prosaic reality" and "dreams of transformation" claptrap is pure Krugman. He mocks Obama's supporters, then says they're the only people who can get health insurance reform to pass. Krugman still thinks Obama is going to lose in November 2008.

Finally, take a look at the reports of the tea bagger protesters being reported at Talking Points Memo here, here, and here.

This does not bode well for the future of this country. Has the Republican Party damaged the American political process beyond repair? Are we never again going to be able to accomplish great things? Is our future going to be held captive to ignorant mobs?

We'll see in the next few months.

Addendum: Andrew Tobias has a very worthy post on health care in America here.

By George, I Think He's Got It!

David Brooks tells us how Obama is going to get us health care. Well worth the read.