Great. Our President literally handing out checks to seniors— to influence their opinions about a political concept. Its like we are back at Tammany Hall again.

Readers may recall some of our first articles which argued that despite assurances to the contrary, President Obama could NOT promise “people who like their present coverage can keep it”.  Simply, it is because employees have little or no say in what benefits an employer chooses to offer.  The Lewin Group, health care consultants, estimated that 118 Million people would lose their employer sponsored insurance and be forced into the National Exchange.  Of course some in Government were more candid in their assessment, at least in front of sympathetic groups.

So …

These articles get at the core issue of HCR from both sides: the administrative/hospital one, and the personal/patient one. Both offer the same insights and raise the same questions. Our contribution to this little dialogue? No matter what rules and laws are put in place to ‘reform’ health care, the fundamental issues that had the Bennett’s making the decisions they made, and the doctors making the ones they made– those issues all remain intact and untouched. Obamacare is foolish. Worse, after reading these articles it becomes plainly evident that Obamacare is also a mirage.

Pre-delivery release of President Obama’s State of the Union address tomorrow night have suggested he will try and adopt a new “Populist” approach after the stinging defeat in Massachusetts.  Central to this effort is a proposal to freeze some areas of discretionary spending for three years, demonstrating that he understands the public outcry over ballooning deficits.  A good start?  Well maybe, or maybe just lipstick on a pig.
The idea of a spending freeze makes great sense for a nation drowning in red ink.  However, this proposal addresses only certain areas …

A few weeks back, the Washington Times ran a really great piece by its Emeritus Editor Wes Pruden. The article calls attention to facts not present in the current discourse. Facts are funny, we know, in the world of politics. One persons truth is another’s cause to rebel. Our public discourse more closely resembles the world of John Adams and the Porcupine Gazette or William Hearst and Yellow Journalism than it does the staid world of the NYT and WP and WSJ as the papers of record. But, there are …

It sad actually. It is no surprise to our readers that we are not avid supporters of the current HCR plan as it now exists. That being said, there remain serious issues with healthcare and a public in support of reform as Mr. Obama inherited in March of 2008 has soured to the point where the concept is essentially revulsive. Making this all so much for sad is that the focus has been shifting slowly away from the actual reform debate in the Senate and instead on to Harry Reid. …

One of our very own bloggers, Dr. Douglas Mackenzie continues to contribute to the discussion on health care reform in multiple venues. Here we reprint with his permission a letter he sent to the American College of Surgeons which was published on the Foundation for Economic Education Website. He makes the impassioned argument that needs to made: its time for physicians to lead the charge and take medicine back under their control. It’s time we stopped just taking it on the chin. We aren’t just cogs in …

We have come across a number of articles of late in main stream news sources that talk of a possible shortage of trained MD physicians if the current versions of the Senate and House bill get passed into law. Now, before we get into the specifics of those claims, it is worthwhile to take more “long term” view of doctor supply over the years. The issues of shortages and surplus in medicine are not at all new– so the first and most important point is that we need to stop …

We have talked about rationing in other posts. It will be a natural consequence of the bills the Democrats have passed in Congress. Advisers to the president such a Peter Singer and Ezekiel Emanuel are proponents of this approach to health care as a way to cut costs. But we could never have predicted that the administration would stumble out of the gates and “attack” breast cancer first. A cause that has touched millions of lives in this country. You can watch an NFL game …

While this post is not meant to be exhaustive, it is illustrative of how things “get done” in the Capitol.  I will update this list as I become aware of additional vote sales in passage of HCR. Stay tuned.

Jim Costa (D-Merced CA) exacted a price for his support of H.R. 3962.  Namely $128 Million dollars.  The funds will be used for a new UC Medical School in Merced CA.  Mr. Costa does not shrink from the fact, he in fact trumpets it on his official Congressional website.  “During my …

What is truly extraordinary here is that Mr. Reid never saw this coming. In the hours and days after the defeat, his office was a model of what not to do. Already looking weak, he continued his efforts and came across as a naif as well.

In the last post of this title I described why Infant Mortality is a poor measure of a society’s medical success.  The main reason: it is a carefully watched statistic and therefore one that Governments manipulate to improve their image on the world stage.  Many countries use non-standard definitions which allow them to exclude the highest risk infants from reported statistics thereby improving their reported outcomes.  In fact, researching the prior post, I learned that there really is NO standard definition of an “infant”, a problem which makes country comparisons …

“Hospital facilities are overcrowded, and long delays in securing treatment are universally noted”. Such was the observation of James Buchanan, economist and (future) Nobel Laureate in 1965. Over 40 years later the situation remains largely unchanged. Published in 2002, The Wanless Report was commissioned to study the failings of the NHS and served as the impetus for increased spending under then PM Tony Blair. It noted among key findings that the UK facilities were aged and in poor repair, that diffusion of new technology was lagging, …

Just as with the AMT, an absolute dollar amount will inexorably lead to an ever greater number of households who become subject to such a tax.

Listening to John Kerry (D-MA) and Debbie Stabenow (D-MI) discuss the draft Senate Finance Bill I was struck at the honesty of the debate.  Each expressed a concern that the Baucus draft would place heavy burdens on lower income families, mandating they purchase insurance, despite such a mandate being a challenge to their bottom line.
Such arguments are refreshingly straightforward.  People of good will may differ as to whether such mandates will help assure universal coverage or are unreasonable given economic considerations.  In fact, President Obama raised this exact concern during …

Before the rhetoric starts to escalate again with the President’s address to Congress, we thought it might be time to recap the situation on HCR. To date, the conversation has been about the proposals put forward in the House, especially House bill HR 3200 and the President’s comments about health care reform. To say the House bill is a boondoggle is kind. It has been a disaster for the Democrats and the President(and the American people for that matter). Between not reading it, making it so …

Anyone who works in health care knows how territorial we doctors can get when someone tries to “invade our sphere”.  Look at the wide array of opinions on nurses being sanctioned to do what was previously a physician-only job (i.e. nurse anesthetists, nurse practitioners, etc).  My personal feelings on CRNAs aside (I will say I have no animosity toward the profession in general), I have to take issue with the American Association of Nurse Anesthetists (AANA) and their recent letter to Speaker of the House Nancy Pelosi regarding the ongoing …

Every time young people ride a bus they’re going to glower at old people knowing what a fat hunk of their paychecks it takes to keep granny around breathing their air.

This is a follow up analysis to why Barack Obama keeps making egregious misstatements about doctors.

So the system is an unsustainable disaster, but you can keep your piece of it if you want.

ue leader would not mislead– they would simply acknowledge defeat and move on. But, the Republicans and the talk of Waterloo has put Mr. Obama into a corner– and it is one that we fear he will try to talk his way out of.

When one can simultaneously qualify for a low income health insurance plan, and be subject to the AMT for wealthy Americans, something is seriously wrong.

Rebooting American Health Care
As you can glean from my previous TBM postings about the politically contrived “health care crisis” and the disingenuous use of euphemisms to disguise the Obama Administration’s true intentions of rationing, I have no faith that our government can, at the same time, raise health care quality and lower costs. In recent history, there is no precedent that suggests they have the capacity to fulfill President Obama’s promises!
Instead, the historical record is littered with big government promises followed by failures. These include the …

We have hard choices to make as a citizenry. People do need help. Our present course of folly however seems to indicate that choices are easy– because there are no consequences. This is obviously false. The question remains: How do we help these people? The answer, as Obama may have said last year, is us. We are what we have been waiting for.

There is ample commentary available on all of these issues from almost any source one looks to. So, instead of parroting these sources, we offer something we hope is unique. In a series of posts following this one, we will highlight and discuss the three major issues as we see them at the present moment. They are titled, simply, The People, The Money, The Consequences. At present, the HCR legislation as it is known, as dire implications for all of these areas. So, read on.

The Health Care “Crisis”
Crisis, literally translated to mean a disaster or emergency, has become a favorite word of the Obama administration. By choosing this word they want to convey to the electorate that there is an impending calamity and, therefore, action must be taken in the blink of an eye to avert certain catastrophe. A more appropriate and telling phrase, that President Obama has used repeatedly is “the stars are aligned.” I translate that to mean he sees, as did LBJ in 1965, the opposition is …

The President’s main case for reform is rooted in false claims and little evidence.

This is a “summary” of the chess board of HCR as seen through the eyes of a California Society Of Anesthesiologists past president. When you think of the all the moving parts and all the moving pieces of the HCR debate, the analysis we crave is difficult to find. This summary is the best we have seen yet.
A Bargain with the Federal Government?
I have just received the latest communication from the ASA that requests us to write our members of the House to tell them that, “Any public plan …

We hear it all the time: other countries spend less on healthcare and everyone is insured. But this article by John C. Goodman takes a look at what we aren’t getting. There is no free lunch. Here at TBM we feel that healthcare has many solvable issues. So far we haven’t heard many solutions that will actually affect meaningful change for the better. A big part of the problem is critical members of healthcare delivery are not part of the discussion. They are …