[Oe List ...] OE Digest, Vol 65, Issue 70

Wed Sep 9 15:42:39 CDT 2009

Dave,

The article by Feldman that you cite points to one of the most important factors producing the high cost of American health care: ?liability insurance for doctors, hospitals, pharmaceutical and medical device manufacturers.? I would add to this the unregulated advertising of prescription drugs that encourages people to self diagnose and demand that their doctor prescribe something they have seen touted on TV, not to mention the electric wheel chair industry spawned by a bureaucratic decision to provide coverage.? Remember the recliners that would stand you up, if you had trouble getting out of your chair?

Doctors and hospitals have had their reimbursement reduced by Medicare stepwise in several?reform efforts, and probably cannot be squeezed much more.? Several specialties have seen their training programs under filled because of the long training required?coupled with reduced reimbursement.? Only 70% of the residencies in cardiac surgery filled this year.? Residencies in Dermatology and Plastic Surgery are over subscribed because much of their services are not covered by Medicare and private insurance, but are on a cash basis, reducing collection costs.? Family practitioners and Internists are having a very difficult time.? Many rely on nurses and physician assistants?to monitor routine problems, freeing them for more difficult tasks, like the paperwork required?by Medicare and insurers.

I am not optimistic that requiring insurance companies to take all comers, regardless of pre-existing conditions would somehow reduce costs.? It?would?simply increase everyone else's premiums.? I know a couple of self-employed people, who maintain a health savings account, have a high deductible catastrophic policy that is affordable and pay their own routine medical costs out of pocket.? They are highly motivated to stay well, and do.? People are motivated to seek only absolutely essential care when they have to pay for it.? 

The status quo is overly expensive, but the currently proposed legislation, H.R. 3200 will not reduce costs without addressing tort reform which will not only reduce costs to physicians and hospitals, but also drugs and devices, and reduce the overuse of xrays, and tests in practicing "defensive medicine".
.

Don Elliott
9400 E Iliff Ave #361
Denver, CO 80231
303 695 4688 (H), 303 378 9175 (C)

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Subject: OE Digest, Vol 65, Issue 70

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Today's Topics:

   1. Re: WH deal with PhRMA, delayed response to Ed (ed feldmanis)

----------------------------------------------------------------------

Message: 1
Date: Wed, 9 Sep 2009 10:00:11 -0500
From: ed feldmanis <edfeldmanis at gmail.com>
Subject: Re: [Oe List ...] WH deal with PhRMA, delayed response to Ed
To: Order Ecumenical Community <oe at wedgeblade.net>
Message-ID:
    <2f38529f0909090800g2b981002u6a324bd3336b0c82 at mail.gmail.com>
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Don,

I appreciate the responses of all of you.  My questions to Susan were in
response to some of the things Susan has said.  Susan believes, as I
understand it, that conservatives have the mission to preserve the best of
what we have.  I wondered if the legitimacy of the conservative point of
view wasn't being absconded with and has been lost due to various factors
including big money.

I think Susan may be working out answers to these things I asked. My point
is that when there are issues of corruption and waste as big as we have,
there may actually be a common ground for legitimate conservatives and real
liberals.  Especially, this may be true when special interest, big,
super-big money doesn't obscure the issues.

2009/9/9 Bill Schlesinger <pvida at whc.net>

>  Whether we call it ?public option,? or ?three-share? or ?universal
> access,?  there?s no way to cover health care for low income folk without
> public funding.  We?re doing it now ? costly, ineffective, and rationed by
> physical access ? through emergency departments and uninsured inpatient
> costs written off in hospi
tals.  We?re also continuing to see a
> disproportionate number of bankruptcies linked to health costs ? often
> avoidable.  We can?t get to a basic level of care for everyone from the
> private sector alone or we?d already be there.
>
>
>
> As far as serving undocumented immigrants:  Will virus and bacteria not
> communicate from undocumented persons because of the lack of documents?  Any
> public health linked service cannot screen out undocumented folk without
> compromising the entire population.  It can?t ?chill? their access by
> reporting, enforcing, or even asking about their documented status.  That?s
> why the Border Patrol has marked clinics as ?off limits? to their vehicles
> let alone actual entry.
>
>
>
> Bill Schlesinger
> Project Vida
> 3607 Rivera Ave
> El Paso, TX 79905
> (915) 533-7057 x 207
> (915) 490-6148 mobile
> (915) 533-7158 fax
> bschlesinger.pv at tachc.org
> www.projectvidaelpaso.org
>
>
>  ------------------------------
>
> *From:* oe-bounces at wedgeblade.net [mailto:oe-bounces at wedgeblade.net] *On
> Behalf Of *Ellen & David Rebstock
> *Sent:* Tuesday, September 08, 2009 11:49 PM
> *To:* Order Ecumenical Community
> *Subject:* Re: [Oe List ...] WH deal with PhRMA, delayed response to Ed
>
>
>
> Dr. Don,
> Just to change the subject a bit.  What do you think about these points in
> the Washington Post that seem to be written from the Doctors and Hospital
> perspective.http .  //
> www.washingtonpost.com/wp-dyn/content/article/2009/09/04/AR2009090402274.html?wpisrc=newsletter&wpisrc=newsletter10 
Things I hate about Health Care Reform
>
> Also another Post article about "why Liberals should drop the Public
> Option" today is also good
>
> http://www.washingtonpost.com/wp-dyn/content/article/2009/09/07/AR2009090702070.html?wpisrc=newsletter&wpisrc=newsletter
> I'm pretty liberal and have been and have experienced the high cost of
> medicine for the last two years.  I've been for single payer or Public
> Option all along but would give up on it if I felt we could just accomplish
> Obama's ove
rall objectives of Universal Care, No pre-existing restrictions,
> costs go down all the way around by whatever means and get at least some of
> the  10 things in the list in the first article  like
> 1. Real regulation of insurance companies and yet a real competitive
> environment.
> 2. Limits on compensation in suits
> 3. Subsidies for education of med students especially those going into
> family practice.
> 4. Not cutting payments to doctors
> 5. Not cutting reimbursements to hospitals so they have to shut down.  But
> they need to cut costs too.  The patient records and mechanization in UCal
> Hospitals is terrible, stone age. They can't find anything.  You virtually
> have to bring your own records with you. Yet every records station is
> grossly overstaffed because the records are still in manila folders
> Including the CDs for MRIs etc.
> 6. Doctors incentives for quality.
>
> What I hate most about the discussion that is going on is on both sides say
> "I've got mine, the hell with you"
>
> Dave Rebstock
>
>
>
>
>
> Dave Rebstock
>
> 2009/9/8 Don Elliott <dpelliott at aol.com>
>
>
>
> Ed,
>
>
>
> Your question to Susan.
>
>
>
> IV. You have not said anything about the flood of money going to Congress
>
> and corruption that happens with wink and a nod rather than outright buying
>
> of votes.  Is there any Conservative outrage about this kind of sneaky
>
> corruption?
>
>  You challenged Susan to say something about the flood of money going to
> Congress in exchange for favorable treatment.  You seem to imply that that
> is a problem of conservatism.  I am providing a link to an article by a
> liberal columnist who is outraged by the deal made between PhRMA and the WH
> which prevents government from negotiating for lower drug prices on the
> basis of volume buying.  Medicare Canada has negotiated for and received
> huge volume discounts.  You can order American made drugs from Canada for a
> fraction of their cost from US pharmacies, so-called reimportation.  The
> Medicare drug bill passed by a Democrat
ic congress under GWB was roundly
> criticised for not allowing negotiated lower drug prices, and now we find
> the Obama WH has done the same thing.
>
>
>
> Surprise, the article has been removed from Robert Reich's blog,  I tried
> posting the entire article, but exceeded my 40kb max.  I will send the full
> article to anyone who wants it.
>
>
>
> Here is a brief excerpt:
>
>
>  *Robert Reich's Blog <http://robertreich.blogspot.com/>* *Sunday, August
> 09, 2009*
>  *How the White House's Deal With Big Pharma Undermines Democracy *
>
> *I'm a strong supporter of universal health insurance, and a fan of the
> Obama administration. But I'm appalled by the deal the White House has made
> with the pharmaceutical industry's lobbying arm to buy their support.
>
> Last week, after being reported in the Los Angeles Times, the White House
> confirmed it has promised Big Pharma that any healthcare legislation will
> bar the government from using its huge purchasing power to negotiate lower
> drug prices. That's basically the same deal that George W. Bush struck in
> getting the Medicare drug benefit, and it's proven a bonanza for the drug
> industry. *
>
>
> *Let me remind you: Any bonanza for the drug industry means higher
> health-care costs for the rest of us*
>
>
> *In return, Big Pharma has budgeted $150 million for TV ads promoting
> universal health.
>
> I don't want to be puritanical about all this. Politics is a rough game in
> which means and ends often get mixed and melded. Perhaps the White House
> deal with Big Pharma is a necessary step to get anything resembling
> universal health insurance. But if that's the case, our democracy is in
> terrible shape.  We're on a precarious road -- and wherever it leads, it's
> not toward democracy.*
>
>
>
>
>
>
>
> The Deal, (from the Huffington Post)
>
> =0 A
>
>  The deal, as outlined in t he memo:
>
> Commitment of up to $80 billion, but not more than $80 billion.
>
> 1. Agree to increase Medicaid rebate from 15.1 - 23.1% ($34 billion)
>
> 2. Agree to get FOBs done (b
ut no agreement on details ? express
> disagreement on data exclusivity which
>
> both sides say does not affect the score of  the legislation.) ($9 billion)
>
> 3. Sell drugs to patients in the donut hole at 50% discount ($25 billion)
> This totals $68 billion
>
> 4. Companies will be assessed a tax or fee that will score at $12 billion.
> There was no agreement as to how or
>
> on what this tax/fee will be based.
>
> Total: $80 billion
>
>
>
> In exchange for these items, the White House agreed to:
>
> 1. Oppose importation
>
> 2. Oppose rebates in Medicare Part D
>
> 3. Oppose repeal of non-interference
>
> 4. Oppose opening Medicare Part B
>
>
>
> Where is your outrage over this?  Is this an example of  "everybody's doing
> it", "secondary integrity", or "the end justifies the means"?
>
>
>
>
> Don Elliott
>
>
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