Thoughts & Commentary on the Obama Administration

[Crazed Rabbit]

AMA donates more to Republicans - they aren't in this for their patients. They are in this for themselves.

*rollseyes*

No, I think a better response is sustained laughter.

The leading Senate-side recipient of its campaign contributions since 1998 has been John Ensign of Nevada, to whom the AMA has given $30,000.

Oh noes! $30k! Over ten years, so about $3k a year. Yup, that's pretty massive.

Really though, the idea that simply because they donate more to republicans they are in this for themselves is absurd. And I mean absurd. What, besides partisanship, could cause you to state that the AMA is in it for themselves instead of simply supporting candidates they believe will do the best for health care? Maybe, as doctors, they have an insight into the fact that public health care isn't good?

If you want partisanship in organizations, look to Washington's teacher's union, which donates above 90% (IIRC) to democrats.

No matter how you feel about Obama, this is pretty cool:

Yes indeed.

CR

[CountArach]

Really though, the idea that simply because they donate more to republicans they are in this for themselves is absurd. And I mean absurd. What, besides partisanship, could cause you to state that the AMA is in it for themselves instead of simply supporting candidates they believe will do the best for health care? Maybe, as doctors, they have an insight into the fact that public health care isn't good?

Nope. Doctors will do better out of private healthcare because they earn more per patient. It's that simple.

[KukriKhan]

Nope. Doctors will do better out of private healthcare because they earn more per patient. It's that simple.

There's talk of eliminating 'per-patient' compensation, and making payment 'outcome based'. This, the doc's don't like much.

And gets the actuarial guys more involved, figuring the odds that x treatment will have y outcome. The fear is: if the oddsmakers decide that the odds are not good enough, = denial of compensation/funding for that treatment.

[Alexander the Pretty Good]

Nope. Doctors will do better out of private healthcare because they earn more per patient. It's that simple.

Those damn doctors sitting on their piles of gold and many beautiful women! How dare those capitalist pigs earn a living for themselves on the illnesses of the workers! We must crush them comrade!

[Lemur]

Nope. Doctors will do better out of private healthcare because they earn more per patient. It's that simple.

Grist for a different thread, I suppose, and we'll probably have one up once the new healthcare proposal gets made public.

That said ...

I don't know a single medical professional who's happy with the way things are now. One of the best doctors I knew in NYC stopped taking health insurance entirely, since he couldn't deal with the forms, the bureaucracy and the aggravation. You paid him cash, and you dealt with the insurance trolls.

Important fact: As the cost of healthcare has skyrocketed, precious little of that money has made it to doctors and nurses. Their incomes have remained relatively flat, certainly not advancing at 14%-20% per year like our healthcare costs.

[Crazed Rabbit]

Nope. Doctors will do better out of private healthcare because they earn more per patient. It's that simple.

So with nationalization, you lessen their pay and the incentive to become a doctor. Great plan. And if the NHS is any guide, the red tape will become worse. If I recall the one NHS doc here hates it.

One of the best doctors I knew in NYC stopped taking health insurance entirely, since he couldn't deal with the forms, the bureaucracy and the aggravation.

My Uncle-in-law joined the army as a doctor because he couldn't pay rising malpractice insurance (which might have been above $100k a year, I don't remember).

Anyways, more hospitals and medical peoples are opposing Obama: http://apnews.myway.com/article/20090614/D98Q5L4O0.html

The president suggests trimming federal payments to hospitals by about $200 billion over the next 10 years, saying greater efficiencies and broader insurance coverage will justify the change. Hospitals, especially those with many poor patients, say the proposed cuts are unfair and will harm the sick and elderly.
...
Obama wants to reduce government payments for such services. He said the devices are used so frequently and efficiently that providers can spread their costs over many patients, requiring less government reimbursement.

The Access to Medical Imaging Coalition, a trade group, disagreed. It said the president's plan would "impair access to diagnostic imaging services and result in patients' delaying or forgoing life- and cost-savings imaging procedures." The group said Obama's efficiency estimates were based on a flawed survey.

And an opinion article by someone at Safeway and the plan they used to keep employee healthcare costs steady for the last four years (since the plan was implemented):

Safeway's plan capitalizes on two key insights gained in 2005. The first is that 70% of all health-care costs are the direct result of behavior. The second insight, which is well understood by the providers of health care, is that 74% of all costs are confined to four chronic conditions (cardiovascular disease, cancer, diabetes and obesity). Furthermore, 80% of cardiovascular disease and diabetes is preventable, 60% of cancers are preventable, and more than 90% of obesity is preventable.

As much as we would like to take credit for being a health-care innovator, Safeway has done nothing more than borrow from the well-tested automobile insurance model. For decades, driving behavior has been correlated with accident risk and has therefore translated into premium differences among drivers. Stated somewhat differently, the auto-insurance industry has long recognized the role of personal responsibility. As a result, bad behaviors (like speeding, tickets for failure to follow the rules of the road, and frequency of accidents) are considered when establishing insurance premiums. Bad driver premiums are not subsidized by the good driver premiums.

As with most employers, Safeway's employees pay a portion of their own health care through premiums, co-pays and deductibles. The big difference between Safeway and most employers is that we have pronounced differences in premiums that reflect each covered member's behaviors. Our plan utilizes a provision in the 1996 Health Insurance Portability and Accountability Act that permits employers to differentiate premiums based on behaviors. Currently we are focused on tobacco usage, healthy weight, blood pressure and cholesterol levels.

Safeway's Healthy Measures program is completely voluntary and currently covers 74% of the insured nonunion work force. Employees are tested for the four measures cited above and receive premium discounts off a "base level" premium for each test they pass. Data is collected by outside parties and not shared with company management. If they pass all four tests, annual premiums are reduced $780 for individuals and $1,560 for families. Should they fail any or all tests, they can be tested again in 12 months. If they pass or have made appropriate progress on something like obesity, the company provides a refund equal to the premium differences established at the beginning of the plan year.

Now, IIRC, Obama doesn't want insurers to be able to charge people with unhealthy habits more. Apparently it's unfair to the unhealthy. Who cares about the healthy - those who stay fit - or about the practical implications (people will have less incentive to stay fit).

Also, Obama is choosing some ambassadorships based on who gave him the most money in the campaign: http://apnews.myway.com/article/20090612/D98OTD380.html

WASHINGTON (AP) - President Barack Obama on Thursday tapped four big Democratic Party donors for plum ambassadorships in Europe and Latin America while naming six career diplomats to posts in Africa, the Mideast and the Pacific.

CR