Wednesday, April 07, 2010

Distinction Without a Difference

Good news from the Newspaper of Record:

The federal government is now starting to build the institutions that will try to reduce the soaring growth of health care costs. There will be a group to compare the effectiveness of different treatments, a so-called Medicare innovation center and a Medicare oversight board that can set payment rates.
Sarah Palin had a more pungent term for this sort of thing.

11 comments:

W.B. Picklesworth said...

Hello Death Panels. Nice to meet ya.

Night Writer said...

These "institutions" - and doesn't that sound eternal - would appear to duplicate what is already being done in the private sector. My company, for example, already serves as a "best practices" center for health plans wanting to know the latest on health procedures and therapies and we participate in a transplant network that significantly reduces the cost of transplants and related care. We have expert physician consultants that our clients can consult at no additional charge about HIV, Oncology, neo- and perinatology and more. We believe a healthy outcome is the most cost-effective outcome in the long-run even if it means a approving a more expensive treatment up-front. We are highly motivated and responsive to our clients' needs and constantly try to anticipate and provide for their emerging needs because we know that if we don't one of our competitors will.

Mr. D said...

Yeah, but you're not a member of AFSCME, NW. So it's no good.

Bike Bubba said...

Reading Nightwriter's comments, one would have to infer that he thinks that people need to be alive in order to pay premiums.

My goodness, what a silly goose! :^) If he wants to be taken seriously, he has got to join SEIU.

Anonymous said...

BIG GOVERNENT AGENCIES = BIG SAVINGS Has this formula ever really worked for anything, other than adding members to government unions.

Anonymous said...

So CQI and process review is now the equivalent of death panels? Wow!

Are you still a fiscal conservative?

Rich

Mr. D said...

Are you still a fiscal conservative?

Yep, last time I checked. Watch how this plays out. By the way, great to hear from you, Rich.

Anonymous said...

So explain to me how health care and cost containment should work. And please don't fall back on the open markets canard, because health care just doesn't work that way. It never has and never will. Markets certainly play a part, but they are not a panacea. So if there can be no oversight, just how are we going to contain costs? I think we can agree that the practice of health care can't be an ongoing episode of House M.D., where panels of expert physicians devote most of their time to individual cases.
The cost of HC continues to spiral out of control in this country. Sniping at every effort to contain costs, whether it be publicly or privately initiated, is BS, and labeling it a death panel is even worse. I know your pissed about HCR, but you can do better than that.

Rich

Mr. D said...

And please don't fall back on the open markets canard, because health care just doesn't work that way. It never has and never will.

And you know this how? We've been locked in a system for the past 60 years where pricing signals don't exist.

Markets certainly play a part, but they are not a panacea.

Never said they were a panacea. But they are the place to start.

So if there can be no oversight, just how are we going to contain costs?

Didn't say there could be no oversight, but who does the overseeing is pretty crucial, doncha think?

I think we can agree that the practice of health care can't be an ongoing episode of House M.D., where panels of expert physicians devote most of their time to individual cases.

Yep. No one disputes that.

The cost of HC continues to spiral out of control in this country.

What is the ideal cost? The percentage we should be spending? How do we determine that? Who determines that? Tell me what you think makes sense.

Sniping at every effort to contain costs, whether it be publicly or privately initiated, is BS, and labeling it a death panel is even worse.

I don't think I was "sniping at every effort to contain costs," but your mileage may vary, Rich. What concerns me is that Obamacare is designed to lead to a single payer system down the line. For all the flaws in the current system, and they are legion, I still have the option to pursue other means to get health care. I worry that if we're all thrown into one bucket, my options will be limited.

Put it this way -- I hope I am wrong. But I doubt that I am.

Mr. D said...

I almost forgot:

I know your pissed about HCR

No, the word would be saddened. This law and the structures it will impose are a huge mistake. And I regret the bills that these profligate Congresscritters are running up, especially since my children are the ones who will be presented with the bill, along with all the others that are coming due now. History will not speak well of the generation immediately before us, Rich. And it won't speak well of us, either, because we didn't do enough to stop this.

Night Writer said...

The third-party payer system - that came about as a reaction to government wage and price controls in the 40s - blinds consumers and insulates providers from the market affect, which has greatly distorted the cost and delivery process. Nobody really knows what something costs (even the doctors themselves, as I've discovered in trying to get estimates for certain procedures) and there's little real competition. While the services provided are valuable and effective the costs are passed on (and on, and on). A nationalized health plan exacerbates the situation and Pres. Obama clearly stated in a speech in Iowa after the bill was signed that this bill was the first step toward nationalized healthcare (I heard it myself).

Costs will continue to rise and when the government is the payer it will have to ration care and will ultimately do it based on who is of most use to the State. This isn't conjecture: it's what Dr. Ezekiel Emmanuel - Rahm's brother and one of Obama's healthcare advisors has written about: http://rightsoup.com/rahms-brother-dr-ezekiel-emanuel-the-death-czar/.

You can also see what has happened in Great Britain. There are numerous examples, but I can two right here:

http://thenightwriterblog.com/2009/07/28/i-dont-want-to-go-on-the-cart/

http://thenightwriterblog.com/2005/04/24/charlottes-web-when-the-state-decides-if-your-baby-shall-live-or-die/

The governmental bodies that decided that the individuals in this case were not worthy of it's life-saving or life-extending benefits were not called "Death Panels" but I'm sure Orwell could come up with some catchy names.

And if you don't think costs will go up under a nationalized plan, consider this:
http://thenightwriterblog.com/2008/04/29/scottish-seniors-not-dead-yet-free-health-care-costs-soaring/