Tag Archives: Health Care

Patients ARE Consumers

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I recently ran across this blog post by Paul Krugman in the New York Times titled “Patients Are Not Consumers“.  A bit more research on Twitter revealed literally hundreds of tweets dripping with fawning praise… thanking Krugman (the God-like figure from the mouth of which all truth derives) for having the courage to say that patients are not consumers.

A sampling of these tweets are included for reference:

Patients are not consumers, doctors shouldn’t just sell a service!

Ndege: RT @jillinski: Thank you Paul Krugman. I have been ranting about this for years. Let’s banish the word “consumer” altogether!

jillinski: Thank you Paul Krugman. I have been ranting about this for years. Let’s banish the word “consumer” altogether!

stellabellaqlts: thank you Mr. Krugman for strongly stating this point! “@NYTimeskrugman: Patients Are Not Consumers

Krugman’s argument (if you want to call it that) is that because medical care deals with life and death decisions, it can’t be put into the traditional ‘economic’ framework:

Medical care is an area in which crucial decisions — life and death decisions — must be made; yet making those decisions intelligently requires a vast amount of specialized knowledge; and often those decisions must also be made under conditions in which the patient is incapacitated, under severe stress, or needs action immediately, with no time for discussion, let alone comparison shopping.

The idea that all this can be reduced to money — that doctors are just people selling services to consumers of health care — is, well, sickening. And the prevalence of this kind of language is a sign that something has gone very wrong not just with this discussion, but with our society’s values.

Now, the problem here… is that Krugman’s entire premise is, well, bunk.  The fact that medical care requires vast amounts of knowledge or that people are incapacitated (on occasion) when they receive care is really irrelevant to the question of what a consumer is… and the nature of the transaction between doctor and patient.  What Krugman can’t bring himself to face… is that the medical industry… is, well, an industry… and doctors have been treating (and will continue to treat) patients because they get paid to do so.

But the bigger question here seems to be this: What is it about being a health care consumer that so troubles Krugman?  Since when did being a ‘consumer’ become a dirty word?  Sure, there are many emotions involved with medical care… but that fact alone doesn’t transform medical care into something outside the realm of markets and economics.  What really seems to be bothering Krugman is that not enough people think that health care is a RIGHT… a right to require one third party to offer some other third party a good or service.

The truth is… turning doctors into indentured servants who are required to perform what are often very difficult social duties… turning the medical profession into a field comprised of obligation and compulsion rather than honor and opportunity… THIS would be truely sickening.

33% of physicians to quit after ObamaCare is passed?

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One wonders if any democrat on capital hill has a clue just how quickly the medical system is going to fall apart as a result of their legislation.  This from a recent study by the Medicus Firm:

nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.

“What many people may not realize is that health reform could impact physician supply in such a way that the quality of health care could suffer,” said Steve Marsh, managing partner at The Medicus Firm in Dallas. “The reality is that there may not be enough doctors to provide quality medical care to the millions of newly insured patients.”

It’s probably not likely that nearly half of the nation’s physicians will suddenly quit practicing at once. However, even if a much smaller percentage such as ten, 15, or 20 percent are pushed out of practice over several years at a time when the field needs to expand by over 20 percent, this would be severely detrimental to the quality of the health care system. Based on the survey results, health reform could, over time, prove to be counterproductive, in that it could decrease patients’ access to medical care while the objective is to improve access.

Furthermore, even if physicians are unable to act upon a desire to quit medicine, there could be an impact in quality of care due to a lack of morale in physicians who do continue to treat patients despite feeling significantly stressed.

via The Medicus Firm.

Health care reform and a free society

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I’m not sure I agree with the entire piece, but there is something undeniable in Jeffrey Kuhner’s piece Friday in the Washington Times:

[Obama's] proposal seeks to create a centrally planned medical economy that will erect a gigantic government bureaucracy based on massive taxes, subsidies and regulations. Mr. Obama is willing to sacrifice his partys political fortunes in November – and even his own re-election in 2012 – because he understands one fundamental fact: Nationalized health care is the heart of cradle-to-grave statism. No country that has ever embraced socialized medicine – Canada, Britain, France, Germany, the Netherlands, Italy – has ever been able to regain economic freedom.

Basically, his point here is that here’s a lot more than just health care for uninsured at stake here… our freedoms, our opportunities, our free market system is at stake.

Now, the incredible Irony here is that back in 2003, when Obama was a state senator and the issue of abortion came up… Obama’s view was that:

I voted uh, uh, no, on uh,the late term abortion ban not because I don’t recognize that these are not painful issues but because I trust women to make these decisions.  To the degree to which we presume as governments to make decisions in the most intimate, uh, basic, uh, decisions of uh, a individual’s life I think we are making a mistake.

So when it comes to abortion… Government has no role to play AT ALL in the choice of women in their medical decisions.  But when it comes to every other medical decision we face… Obama wants to make sure his breaurocracy, his funding, his rules, his limitations all apply to all of our uh basic, uh, intimate, personal decisions… which is all this health care bill ever was… a piece of legislation designed to force most Americans into giving up control over their health to a health-care system run by Obama.

And you wonder why people are angry.

via KUHNER: The United Socialist States of America – Washington Times.

Will there be doctor shortages?

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Allysia Findley has written an interesting piece in the WSJ — discussing a point often missed in the health-care debate:  Doctor shortages:

Mr. Obama wants to provide insurance for an additional 30 million Americans, but recent experience in Massachusetts shows that universal coverage will result in an even greater physician shortage and longer waiting times for patients.

Because Massachusetts’ Commonwealth system served as the model for the universal coverage Mr. Obama wants to implement nationwide, a few results of its health-care experiment are worth noting. A 2008 Physician Workforce Study by the Massachusetts Medical Society found that the percentage of residents having difficulty getting care rose to 24% from 16% between 2007 and 2008. Since 2006 when the Commonwealth system was implemented, internal medicine and family practice went from having labor market conditions that were considered “soft” or unstressed to being the only two specialties with labor market conditions classified as “severe” or experiencing the highest possible degree of stress.

This is stunning to say the least:  AFTER the government stepped in to the health care arena — promising that MORE PEOPLE would get better care, the percentage of residents having difficulty getting care rose 8%.  In other words, when markets were able to act more efficiently, a higher number of people were able to access more care.  Under the new government-mandated Massachusetts program went into effect, more people had trouble accessing care than before.

This raises the obvious question:  what kind of health care system do you want, a private system that restricts access based on cost (but treats more people)… or a public system that doesn’t “limit” care, but ultimately treats FEWER people.

I’d rather see the most people get the most care… but that’s just me.

via Obama’s Doctor Shortage – WSJ.com.

an (un)educated citizenry?

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I was skimming through my usual RSS feeds and was pleasantly surprised to find this insightful article on The Corner blog.  Mr. Finn, in his article, points out just how difficult a public debate on health care can be when the background knowledge required to fully understand the debate extends over so many fields of study.  Here’s his main point:

What I’m most struck by, however, is the enormous amount of background knowledge — across multiple disciplines — that one must possess in order to understand this debate. It’s almost a litmus test of cultural literacy. Consider, for starters, just three short paragraphs from President Obama’s address to Congress last week:

I am not the first President to take up this cause, but I am determined to be the last. It has now been nearly a century since Theodore Roosevelt first called for health care reform. And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way. A bill for comprehensive health reform was first introduced by John Dingell Sr. in 1943. Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.

Our collective failure to meet this challenge — year after year, decade after decade — has led us to a breaking point. Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are not primarily people on welfare. These are middle-class Americans. Some can’t get insurance on the job. Others are self-employed, and can’t afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer. Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.

We are the only advanced democracy on Earth — the only wealthy nation — that allows such hardships for millions of its people. There are now more than thirty million American citizens who cannot get coverage. In just a two year period, one in every three Americans goes without health carecoverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone. [Emphasis added throughout.]

I’ve marked a few of the many terms, concepts, people, and formulations that demand background knowledge.

He goes on to ask several interesting questions to explain just why this statement is not quite as straightforward as one might expect:

  • Who were Theodore Roosevelt and John Dingell Sr. (and Jr.), and what’s the relevance of their past experience to our present debate? How does the past shape the present?
  • What are key differences between Democrats and Republicans? Why did Obama invoke both? Is it coincidental that he also named Roosevelt and Dingell?
  • How does “insurance” work? What do insurance companies do? What do employers do in this realm? What does it mean to be “self-insured”? What is “coverage”? “Bankruptcy”?
  • What’s an “advanced democracy”? How many are there? What are some others? What’s the point of Obama’s comparison of the U.S. with other countries?
  • Some other essentials: What are Medicare and Medicaid? Where did they come from? How do they work? Who is covered by them?
  • What’s the federal deficit, and why are some people concerned about its size?
  • What is the congressional legislative process, and why is it unusually complex in this instance?
  • What is “health care reform,” and what’s the significance of adding the word “comprehensive” to that phrase?

This post reminded me of a conversation I recently had with an old college friend of mine.  We were having dinner and the conversation eventually landed on the topic of health care… and I asked my friends a question: Listening to Obama, do you think we have a health care problem or a health insurance problem?   The reason I asked was because it seemed to me that nobody in washington really is able to explain which of these problems they are trying to solve.  Obama speaks of both… but often without explaining the different policy prescriptions that are designed to address each specific problem.  I argued that nearly everyone in this country gets basic care… and therefore it didn’t seem to me that we had much of a health CARE problem… but even in the above Obama quote, Obama still maintains that he is enacting health CARE reform… and is causing alot of un-necessary confusion in the process.

I hope this helps you understand just how difficult this debate can be… and why tensions are high.

via Health Care and an Educated Citizenry by Chester E. Finn Jr.

A Health-Care Question…

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Thomas Sowell pretty much NAILS it on the head… If this health care plan is so great and its benefits so apparrent… why do we have to wait until 2013 to start enjoying it?

One plain fact should outweigh all the words of Barack Obama and all the impressive trappings of the setting in which he says them: He tried to rush Congress into passing a massive government takeover of the nation’s health care before the August recess — for a program that would not take effect until 2013.

Whatever President Obama is, he is not stupid. If the urgency to pass the legislation were to deal with a problem immediately, then why postpone for years the date when the legislation would go into effect — specifically, until the year after the next presidential election?

If this is such an desperately needed program, why wait for years to put it into effect? And if the public is going to benefit from this, why not let them experience those benefits before the next presidential election?  If it is not urgent that the legislation go into effect immediately, then why don’t we have time to go through the normal process of holding Congressional hearings on the pros and cons, accompanied by public discussions of its innumerable provisions? What sense does it make to “hurry up and wait” on something that is literally a matter of life and death?

If we do not believe that the president is stupid, then what do we believe? The only reasonable alternative seems to be that he wanted to get this massive government takeover of medical care passed into law before the public understood what was in it.Moreover, he wanted to get re-elected in 2012 before the public experienced what its actual consequences would be.

via Listening to a Liar by Thomas Sowell on National Review Online.

health care semantics

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For the past couple days, I’ve been engaged in a very long and lengthy discussion with someone with whom I am “barely acquaintance” (as she likes to say)… about the topic of Health Care.  Fortunately, I am incredibly well-prepared to discuss the topic having given a speech on health care only a few weeks ago.   We didn’t agree on much, but to my great surprise, it turned out to be a rather amiable discussion… peppered with various challenges, counters, accusations, and, best of all, compliments.

One of the points that really stuck with me was an issue I think has gone largely un-noticed in the debate over universal care, and that is: what kind a problem is universal care?  You see, the primary proponents of universal care are in almost complete agreement that the lack of universal care is a HEALTH CARE PROBLEM.  Now, this argument was made during the course of the conversation and it (metaphorically) struck me how this semantic ‘slight of hand’ is going almost completely un-noticed by many on the right who’s jobs it aught to have been to discover this flawed line of reasoning.

You see, nobody claims that there is a fine dining “problem” because not everyone can afford dinner and a bottle of wine.  Nobody claims that we have an aviation “problem” because not all people can afford a plane ticket.  Nobody can reasonably claim that we have an entertainment “problem” because not everyone can buy a new television set.    But for some reason, many on the left say we have a health care problem because insurance companies won’t sell insurance to people who cannot afford it.

By now, you have undoubtedly arrived at the rhetorical question:  Is this really a Health Care problem or is it a problem of some other kind?  And your instincts would be correct!  What the left referrs to as a health care problem is really some form of social “problem” — especially to those who think that our society should insure everyone.  A Health Care problem would be defined as bad care or ineffective care.  Failing to give coverage to all is only a problem if you assume a-priori that SOCIETY should pay to cover everyone.   They wrongly claim that the problem of the uninsured is a health care problem when it really isn’t.

The problem here is that many on the left who want to see society change to align with their own social vision are not really being honest about their intentions.  The left is trying to enact sweeping social changes under the guise of economic reform.  If the American people knew that the left wanted to fundamentally change the underpinnings of our society… the American people would have said no to any attempt to pass this bill.  However, when social changes are promoted under the guise of “competition” and “cutting costs” and the many other market-based principles that most Americans believe are best for society, it is often hard to see the underlying agenda.