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Why Obamacare will Fail, in 1 word.

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November 19, 2009 – Comments (66)

"Unchanged."

That's what Obama's knucklehead head of HHS said about mammogram screening. The policy will remain unchanged.

That comes in the face of many studies, mostly supported, from what I've read, by physicians and organizations involved with this type of cancer, which suggest less screening is necessary. The arguments are a little complex, but boil down to:

1) too many screenings don't change mortality rates (because we don't know enough about what kinds of lumps actually become deadly.

2) too many screenings cause harm, both by radiation exposure and by increasing the number of procedures performed that aren't necessary.

Of course, if you or a loved one finds a lump in a breast, you don't want to be told it's probably OK. You want it out, or taken care of -- even if there's no concrete proof that this will bring better health. And therefore, of course, people want screening as often as someone else will pay for it, so that more lumps are caught, more often.

The patients feel better (or think they do). The providers get to cover their butts, even if they don't think the screens are always necessary. The radiology industry likes it, because of that ching ching sound. And politicians like it, because it makes them sound like they're protecting the downtrodden against whatever strawman they choose to torch, in this case, a task force made up of researchers and health care professionals who care very much about women.

Health and Human Services Secretary Kathleen Sebelius, in a written statement, said the new guidelines had "caused a great deal of confusion and worry among women and their families across this country," and she stressed that they were issued by "an outside independent panel of doctors and scientists who . . . do not set federal policy and . . . don't determine what services are covered by the federal government."

She added: "My message to women is simple. Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for years -- talk to your doctor about your individual history, ask questions, and make the decision that is right for you."

And that's why Obamacare will fail. Sebelius is clearly pandering on Obamas behalf. "Ignore the findings of the task force we ourselves assembled! If you think you know better than a team of experts, then so be it! Get tested as often as makes you feel better!"

Our healthcare system is already doomed because no one wants to make the hard decisions on what procedures are necessary and should be paid for. That's why the sky's the limit, and insurance premiums follow.

Politicians, however, are the absolute worst people for this job, and not because of the "death panel" argument promoted by boneheads on the right who are avoiding facts to score points with scare tactics. It's for the opposite reason. No politician anywhere is going to endorse any decision that looks like it will result in less care -- even if there are perfectly sound medical reasons for doing so.

It's not the death panel you need to fear, but the "everything if that's what you want" panel that already exists in government, and will get more power if health care reform is done wrong.

Of course, we have only ourselves to thank for this. We've elected people who are letting policy be set by Fox News.

By Tuesday night, the rationing argument had made it to Fox News, prompting a quick response on an administration blog.  

By demanding care we don't understand, and might not need, simply because we seek to avoid worry, we're telling our providers, "Run up the bill!" And when we do that, we guarantee we'll be paying that bill (and our neighbors') through increased premiums. And neither Democrats nor Republicans have a solution for this, because unless you are prepared to foot your entire health care bill out of pocket, the solution is rationing. It has always been rationing. That's what the private insurers do already, and it's what any public insurer will have to do. Everyone can't have everything. It's that simple. But to say so on the health care debate is political suicide, which is why insurance companies (no saints, but not very profitable either) are the targets of all the beatings. They're the only ones who dare admit that choices have to be made.

It is sometimes said that people get the government they deserve. In this case, we should add that Americans have gotten the bankrupting health-care system they deserve. If they want it otherwise, they should consider the possibility that everything costs something, and everyone can't have everything.

Yeah, I won't hold my breath either.

Sj

66 Comments – Post Your Own

#1) On November 19, 2009 at 9:05 AM, JakilaTheHun (99.94) wrote:

Great blog, Bent.  We need more intelligent arguments on the health care debate rather than the mindless drivel that passes as political dialogue in the mainstream media.  It's sad what our system has evolved into. 

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#2) On November 19, 2009 at 9:13 AM, chk999 (99.98) wrote:

Excellent post Bent. I personally think we should ration care to people that ride recumbent bikes. They are a suspicious lot. (Just kidding.)

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#3) On November 19, 2009 at 9:13 AM, mistertero (< 20) wrote:

Thanks for finally saying this out loud.  I have nothing to add - it is perfect on its own.

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#4) On November 19, 2009 at 9:18 AM, rofgile (99.25) wrote:

I disagree with you on this one - 

I've known people who developed breast cancer early in their life.  It seems to me that mammograms are a useful tool, even early on.

A better way to save money would be to develop a strong preventative medical program.  Push exercise, good diet (regulate foods?), have everyone get general checkups yearly (advocate non-smoking, etc).

Hospitals are the real driver of medical costs, but it is hard to demonize the hospitals and doctors for driving up costs.   

 -Rof 

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#5) On November 19, 2009 at 9:19 AM, catoismymotor (< 20) wrote:

+ 1 Rec.

Have you submitted this to be published as an article?

 

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#6) On November 19, 2009 at 9:26 AM, angusthermopylae (40.09) wrote:

What amuses me about the whole thing is this:  For twenty years, screening early and often was pushed as "the only way."  "If you care..."  "If you have a history..."  "Even if you don't have a history..."  The concept was foisted upon the public that not performing these tests was a sign of neglect and poor education.

Now, however, a government body is saying, "Hmmm...It's not really helping.  You shouldn't get those tests as often."

So which is it?  Were you wrong, arrogant, and premature before, but you're all better now?  Or are there other concerns now that influence the decisions?  Why should the opinion be any better this time around?

Our healthcare system is already doomed because no one wants to make the hard decisions on what procedures are necessary and should be paid for.

It doesn't matter which side of the mammogram-debate you're on--that pretty much sums up the entire problem...and worse, every proposal is argued as "We have to do it this way, or else!"  Then, when the data doesn't bear it out (or priorities change), you get a lot of angry mobs asking, "What the heck is going on?"

(I know I'm going to get in trouble for this, but I can't help thinking how this applies to bailouts, GM-Chrysler bankruptcies, the Iraq invasion, global warming....they all seem very similar...)

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#7) On November 19, 2009 at 9:41 AM, ChrisGraley (29.95) wrote:

Now, however, a government body is saying, "Hmmm...It's not really helping.  You shouldn't get those tests as often."

Our healthcare system is already doomed because no one wants to make the hard decisions on what procedures are necessary and should be paid for.

The real problem that makes healthcare doomed is that I should be making those decisions for myself, not forced into a process where someone makes them for me.

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#8) On November 19, 2009 at 9:50 AM, TMFBent (99.82) wrote:

The real problem that makes healthcare doomed is that I should be making those decisions for myself, not forced into a process where someone makes them for me.

Agreed, but the faulty assumption the right-wing scaremongers use is that you are in control now. You aren't.

Unless you pay all your medical bills in cash (and not so much even then) someone out there is deciding how much care you get for the premiums you pay. That won't change with a government run plan. 

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#9) On November 19, 2009 at 10:01 AM, outoffocus (23.12) wrote:

 If they want it otherwise, they should consider the possibility that everything costs something, and everyone can't have everything.

The same goes for:

Social Security

Medicare

A healthy economy

Home ownership

Credit Cards and

Entreprenuership

Only when America learns that lesson will we get back on our feet.  Until then, we're screwed.

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#10) On November 19, 2009 at 10:07 AM, clanza875 (34.31) wrote:

I completely disagree. The health care issue can only be solved by people taking better care of themselves. Americans feed their fat faces full of McDonalds, wash it down with coca-cola, and then look for a magic pill to solve their health issues (Merck and Pfizer). All of this in a vein attempt to get the DOW to go up at any cost possible. Wake up you greedy morons, this has nothing to do with mammograms. The fat lazy entitled american lifestyle needs to come to an end.

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#11) On November 19, 2009 at 10:12 AM, Gemini846 (65.28) wrote:

Super article. Great analysis. Why can't I read this stuff on syndicated articles instead of the same crap vomited all over the place by people who just keep talking because they get paid.

The solution is simple. Either accept a level of rationing that the person paying for your care (taxpayer) is willing to accept or out-earn the problem and pay cash. That's where Europe and the US differ. Europe has accepted this and we haven't.

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#12) On November 19, 2009 at 10:20 AM, RaulChapin (< 20) wrote:

Good point, for the article. Bent

Rofgile: the point is not that mammograms are not useful, it is that they might be over used. The risk of undetected cancer is there, so the more often you do a mammogram the less likely it is that a breast cancer can go undetected, the question though is at what point the benefit diminishes enough so that the cost is too high to warrant doing one more mammogram?

As with any limited resource, there will be plenty of examples of people who should have gotten one but did not. Now it is INSANE to think that all risk can be eliminated, risk can only be controlled and calculated risk has to be taken in order to function.

The problem with healthcare might be that the reward of a procedure is not meassured only as the possibility of preventing a dissease that would be more costly (in terms not of only money but human suffering) but also meassured by how popular a politician would be by allowing or disallowing certain procedures.

Imagine if we all had to wear bullet proof vests (paid by the goverment of course) to reduce the risk of dying from being shot. I am sure you can easily find a story about some one who died from a lost bullet, or someone who died because they got robbed and then shot... but the question again is: does the risk of being shot warrant the cost of always wearing a bullet proof vest? It is for policemen and army personnel, but not as clear for daycare attendants and accountants. (a maybe would go for postal workers LOL)

The rationale above would be the same for say doing mammograms for older women that might be at a higher risk and not doing them as often for younger woman that might be at a lower risk. Again if you were to pay for your test and wanted to do it twice a day to be sure... you are free to do so, but as long as some one else is covering the costs of risk prevention... then it gets tricky.

But do you want to be the politician that says don't give mammograms to anyone under 25... and then see your political career be over because a big article comes out of one 24 year old who died form the dissease and would have been saved had she gotten a mammogram at 23... its not her money , its not your money, so you dont take the risk!!

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#13) On November 19, 2009 at 10:34 AM, TMFBent (99.82) wrote:

Imagine if we all had to wear bullet proof vests (paid by the goverment of course) to reduce the risk of dying from being shot. I am sure you can easily find a story about some one who died from a lost bullet, or someone who died because they got robbed and then shot... but the question again is: does the risk of being shot warrant the cost of always wearing a bullet proof vest? It is for policemen and army personnel, but not as clear for daycare attendants and accountants. (a maybe would go for postal workers LOL)

Precisely. And remember, this is all completely screwed up by our perception of risk, and that is screwed up by our blood-chasing media. Report on a mass murder or terrorist attack and everyone rushes to figure out how to spend money protecting "the children" from a horrific, but microscopic risk.

Meanwhile, they pile the kids in the car, eat with a double big mac in one hand, a cell phone in the other,ignore the speed limit and complain about red-light cameras restricting their freedom, creating one of the biggest killers in the U.S.

Individuals are horrible at deciding what risks matter, but politicians are worse, linking recency bias and vividness bias with personal aggrandizement via other peoples' money.

Everyone does a better job of at least keeping things economical if they have to pay the true costs. A system that avoids transparency in one of the most expensive personal economies we have will never function rationally.

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#14) On November 19, 2009 at 11:05 AM, GraemesPSP (99.64) wrote:

Great post.  Succinct and the most accurate dipictions of what is wrong with the system.  It should be on the front page of every newspaper in the US.

The real problem that makes healthcare doomed is that I should be making those decisions for myself, not forced into a process where someone makes them for me

I disagree with this completely. You can and should make the decisions yourself, with your own money.  But when it is other peoples money paying then it definately should be done on a cost benefit basis

If I was allowed the freedom to choose my health treatment paid for by others money, I'm pretty sure that I would decide, for the sake of my mental health and general feeling of well-being, that I needed a face that looked just like Brad Pitts.  Probably done in an exclusive 5* facility in Paris, preferably with a week or two prior to settle in, and maybe visit eurodisney.

 

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#15) On November 19, 2009 at 11:15 AM, wolfhounds (28.99) wrote:

This piece couldn't have been published by a woman. I wonder what your stance would be if some government panel said, Oops, we really didn't mean men should actually have prostate exams. They can stick a finger where the sun doesn't shine every two years and figure it out themselves.

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#16) On November 19, 2009 at 11:19 AM, whereaminow (45.39) wrote:

The one word is Collectivism.

David in Qatar

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#17) On November 19, 2009 at 11:34 AM, davejh23 (< 20) wrote:

This was discussed on the Today show this morning.  Sebelius mentioned that the recommendation was based on world-wide data.  So, it might not be wise to change the recommendation for the US where cancer rates are higher...  If we collectively lived healthier lifestyles, then perhaps waiting an extra 10 years to get these tests would be okay, but it might not be a wise recommendation for now.  For those who have a family history of women getting cancer in their 30's, they obviously shouldn't wait until age 50 to get tested.

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#18) On November 19, 2009 at 11:43 AM, whereaminow (45.39) wrote:

We could let the patients and doctors decide what is best for them. Nah..... Let's just tell everyone what to do.

David in Qatar

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#19) On November 19, 2009 at 11:44 AM, outoffocus (23.12) wrote:

For those who have a family history of women getting cancer in their 30's, they obviously shouldn't wait until age 50 to get tested.

Right, but that distinction was made with the original recommendation.

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#20) On November 19, 2009 at 11:50 AM, TMFBent (99.82) wrote:

This piece couldn't have been published by a woman. I wonder what your stance would be if some government panel said, Oops, we really didn't mean men should actually have prostate exams. They can stick a finger where the sun doesn't shine every two years and figure it out themselves.

I was wondering when we'd get the passionate gender-baiting.  I'm glad you did it, because it confirms exactly what I'm saying, which is that the public cannot handle the idea that less testing might be OK

When people are afraid and don't understand the totality of the statistics, they will always opt to do the testing, especially if they think someone else is paying. Exactly what I'm saying. The public and political response will always be: We can't do less testing, because it is (fill in the blank)

Sexist
Racist
Classist
Scary

Your allegation of a double standard is, by the way, false. In fact, the same exact arguments have been made abour prostate exams, which result in large numbers of procedures done on very slow-growing tumors which, if left alone, wouldn't do much. Many men suffer terrible side effects from having growths removed that don't need to be removed.

Again, perception is the problem (along with the idea that someone else is paying.)

No one thinks about the guy whose lower unit was mangled needlessly. He's still alive, and he's not getting any press.

The only thing we remember is the guy we heard about who didn't get it done, who beat the long odds and got caught with a fast grower that killed him -- and whose doctor was sued for malpractice simply for giving the man THE CHOICE to get the test done or not. When THE PATIENT made the choice not to, the later claim was that the doctor should not have provided him information that argued against testing. As a result, the doctor will never again let his patients make the choice. He will make the choice for them, even though the statistics show the potential harms, because he doesn't want to be sued again, and, of course, because someone else is paying.

Thanks for proving my point for me, Wolfhounds.

As for Sebelius, she's now looking for excuses to ignore the study her organization committed -- not because the data are bad, but because the political consequences of arguing against unneeded and harmful over-testing are too tough for Obama to handle.

Sj

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#21) On November 19, 2009 at 11:57 AM, oldandproud (< 20) wrote:

I would like to see what we can and cannot do be the decision of the doctor and the patient..  Right now the decision is made by Insurance companies and they look for the bottom line to help make this decision, which stinks.  Drugs prescribed by doctors should be given without an insurance company having any say in the matter.  Obama's healthcare panel is led and funded by the insurance companies...they have way too much power as it is.  And when we begin to take away preventative steps that can prevent cancer and the like, then what is it we are offering to the people?....A healthcare program that won't allow necessary tests that can ensure good health isn't beneficial to anyone but the insurance companies........and certainly no better than anything we have in place now.

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#22) On November 19, 2009 at 11:57 AM, jstegma (29.37) wrote:

Breast cancer screening was an extremely politicized issue, even before this recent report came out saying to wait until age 50. Having this situation come up just as Obama is trying to pass a more socialized form of health insurance gives us a good look at some of the issues to be considered in any type of healthcare reform debate.

This issue is a perfect example of the collision between economics and wanting better healthcare.  Setting aside the idea that the mammogram itself might cause harm, you have a situation where it might make economic sense to cut down on screenings and let a few more women die of breast cancer, but of course that idea isn't very palatable.  Nonetheless it makes sense from an economic standpoint if resources being wasted on mostly unproductive screenings could be used for a more productive purpose.  You could have a net gain in lives saved if resources were more efficiently allocated.  

But then you get the problem of personal choice.  Normally situations like this are resolved by choosing whether or not to pay for the screening, and the person acts as their own "death panel".  However, in a "health insurance" system like ours, someone else has to assume the role. 

Healthcare resources are scarce.  You can't give everyone everything.  Somewhere, someone is going to die for lack of healthcare.  It is nice to think that Obama or someone is going to solve that problem, but the warm fuzzy doesn't hold up if you think it through.  To be sure, there are benefits to more socialized medicine, but the more socialized healthcare gets, the less personal choice you'll have.  As with all things in economics, there's a tradeoff.

 

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#23) On November 19, 2009 at 12:25 PM, ChrisGraley (29.95) wrote:

Unless you pay all your medical bills in cash (and not so much even then) someone out there is deciding how much care you get for the premiums you pay. That won't change with a government run plan.

True, but I have the next closest thing.

I have a very high deductable health care plan and an HSA. I have enough in my HSA to pay for my deductables for much longer than my lifespan and also to pay for any care that isn't covered by my plan. My HSA allows self directed investment which I take full advantage of. My health care plan has great catastrophic coverage, which is all I'm really looking for. If I want to get something elective like Lasik eye surgery, I simply hand the doctor the debit card connected to my HSA.

When the government comes up with a plan that gives me that much power in the decision making process, I might listen.

 

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#24) On November 19, 2009 at 12:28 PM, wolfhounds (28.99) wrote:

Hey TMF, if one life is saved because of testing it is worth the cost. So, I didn't make your case. You obviously value statistics over saving lives. Sort of (no, exactly like) the officers who commanded me in Vietnam.

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#25) On November 19, 2009 at 12:32 PM, ChrisGraley (29.95) wrote:

I disagree with this completely. You can and should make the decisions yourself, with your own money.  But when it is other peoples money paying then it definately should be done on a cost benefit basis.

Dave has a great answer for that.

The one word is Collectivism.

The point is that right now I do get to make the decisions because it is my money (to some extent) and I believe that I have a right to control my own destiny. The government is seizing that right, "for my own good" so they can make the tough decisions, "for my own good" which they won't make for political reasons. I'm still waiting for the reason that justifies seizing my right of self-determination.

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#26) On November 19, 2009 at 12:38 PM, ChrisGraley (29.95) wrote:

wolfhounds Hey TMF, if one life is saved because of testing it is worth the cost. So, I didn't make your case. You obviously value statistics over saving lives. Sort of (no, exactly like) the officers who commanded me in Vietnam.

Hey wolfhounds, if life were that simple it would be great, but who dies to pay for the money that we spend on the unecessary tests? The money to pay for them comes from somewhere. What do you cut? Treatment for premature babies? Cancer treatment? That's why I prefer to make my own decisions.

 

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#27) On November 19, 2009 at 12:42 PM, whereaminow (45.39) wrote:

wolfhounds seems to be under the impression that resources are infinite, particularly in the medical industry.  No amount of evidence to the contrary (all of human history, for example) is dissuading.

David in Qatar

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#28) On November 19, 2009 at 12:49 PM, bigpeach (26.37) wrote:

if one life is saved because of testing it is worth the cost

And here is why we have atrocious healthcare that, despite being atrocious, manages to consume more wealth than any other country in the world. Because people think infinite resources should be spent on single individuals. Guess what? Resources are finite, whether you realize it or not. That extra cost that you say is 'worth it' doesn't come from some bottomless pool of wealth. Every time a needless procedure is performed, something else is sacrificed.

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#29) On November 19, 2009 at 12:50 PM, TMFBent (99.82) wrote:

Hey TMF, if one life is saved because of testing it is worth the cost. So, I didn't make your case. You obviously value statistics over saving lives. Sort of (no, exactly like) the officers who commanded me in Vietnam.

That's a fairy tale. It presumes that economics don't apply to lives, and they do. It also presumes that the statistics aren't concerned with the greater good, and they are. Remember, these studies go to great lengths to balance lives saved via testmania and lives lost or scarred because of it.

But again, your refusal to concede that lives have cost proves my point. The public wants to believe no expense is too high to save just one life. But the public doesn't want to pay what that costs.

CG, good point. When I was buying my own insurance, I always went with high deductible plans. Basically, I covered a huge proportion of my everyday costs, and got, in turn, a pretty good guarantee that a low probability even (car accident, etc.) wouldn't bankrupt me.

Unfortunately, most Americans want to have every little thing paid for, along with every big thing.

A note, however. None of the plans out there now remove your "right" to choose what you spend on health care. They don't eliminate private insurance nor high dedictible plans.

Sj

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#30) On November 19, 2009 at 12:50 PM, topsecret09 (37.32) wrote:

   Constitutionality......          http://townhall.com/columnists/WalterEWilliams/2009/11/11/a_minority_view_constitutional_contempt

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#31) On November 19, 2009 at 1:00 PM, topsecret09 (37.32) wrote:

http://live.radioamerica.org/loudwater/player.pl?name=wnd&url=http://feeds.radioamerica.org/podcast/DWP/audio/000007_014687.mp3

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#32) On November 19, 2009 at 1:06 PM, TMFHousel (91.79) wrote:

For most of the past two years, I bought my own health insurance. $75 a month. $5,000 deductible. Like Seth said, "I covered a huge proportion of my everyday costs, and got, in turn, a pretty good guarantee that a low probability even (car accident, etc.) wouldn't bankrupt me."

I was extremely picky and choosy regarding what treatment I received, how much it cost, and whether I could get a better deal somewhere else. 

Just recently, I got coverage from my girlfriend's employer. It's darn good coverage, and pays for just about anything I want. Suddenly, I couldn't care less how much anything costs. We just moved, and when I found a new dentist, I didn't bother to ask what they, or their competitors, charge. My insurance covers it, and that's all I care about.

While I'm acting rationally, it highlights exactly what's wrong with our health care system. I have no incentive to care about price, yet we pretend it's capitalism at work. 

-Morgan  

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#33) On November 19, 2009 at 1:09 PM, TMFBent (99.82) wrote:

Come on, topsecret. That article is lame, even by the low standards that apply at townhall.

I despise Comrade Pelosi as much as the next human being, but those who demand a constitutional example for legislation they oppose are those who haven't read and/or don't understand the constitution.

The majority of people who use these kinds of arguments are like flat earthers. They've decided what they believe and reason only makes them more entrenched in their flaky opinions. They're also, to a person, cynical opportunists, choosing to demand a constitutional mandate for legislation they oppose, while conveniently ignoring the nonsensical standard for legislation they like for overt reasons, or legislation they enjoy without thinking about (Farm subsidies, road-building bills, consumer protection statutes, criminal statutes, or whatever)

What Pelosi should have responded to this moronic query was: "Where in the constitution? Article 1, sections 1 and 8, among others. Have you bothered to read them, you fatuous nutjob posing as a reporter?"

At least, that's what I would have responded.

And that's why I'm not in politics, and never will be.

Sj

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#34) On November 19, 2009 at 1:12 PM, QualityPicks (29.15) wrote:

I've always believed insurance is supposed to pay for major events so we don't go broke. Any type of government intervention should follow along those lines. People need to share the financial pain to some degree so that everybody cares about costs and they would only do things if they are necessary.

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#35) On November 19, 2009 at 1:16 PM, Bamafan68 (98.47) wrote:

We have been having a great deal of discussion about this study in the doctors' lounge.  It basically boils down to where you want the tipping point to be: more advanced stage breast cancer becaues it hasn't caught at an early stage, or more money saved on not performing screening until a later age.

The whole "unnecessary surgery, fear and anxiety" in patients with false positive screening mammograms that the study raises is something of a non-starter.  The vast majority of my patients, and the patients of the other ob/gyns I spoke to, would prefer to have an "unnecessary" open breast biopsy than advanced stage breast cancer.

Please keep in mind that not all doctors agree with this study because it was a review study of existing literature from multiple countries.  As much as our friends across the pond and Canada would like to think otherwise, the technology they utilize for the majority of screening mammograms is not what is utilized here.  They tend to perform more plain film rather than digital mammograms.  This not only affects detection rate but also amount of radiation provided to the breast tissue.  The only way to definitely put this issue to the test is to perform a randomized clinical trial utilizing standardized equipment and detection methods.

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#36) On November 19, 2009 at 1:19 PM, outoffocus (23.12) wrote:

 Cartoon by Bob Englehart

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#37) On November 19, 2009 at 1:22 PM, studio42 (39.38) wrote:

Chris Grailey wrote: When the government comes up with a plan that gives me that much power in the decision making process, I might listen.

 

This is almost as good as the people screening at their congressman to keep government out of thier Medicare. Your HSA plan was created by the Medicare Prescription Drug, Improvement, and Modernization Act which was passed in 2003 by the government!

 

The original post by TMFBent makes one critical point with which every fool should agree: these critical issues should be decided based on facts and analysis not ideology or emotion.

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#38) On November 19, 2009 at 1:25 PM, TMFBent (99.82) wrote:

@ OOF. Nice cartoon, despite (or actually, because of) the fact that it pretends there's no medicine in that study.

Just the kind of media knee-jerk over-simplification that will guarantee health care costs continue to rise to unaffordable levels.

Sj

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#39) On November 19, 2009 at 1:33 PM, actuary99 (93.09) wrote:

This blog entry is amazing. Right on the money. Thank you.

Looking at the proposed reforms you would think that the health care crisis is all about poor access to care. The reason you would think this is because there is nothing (I repeat, nothing) in the proposed bills that would lower the price of health care. Take it from someone who analyzes healthcare costs for a living.

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#40) On November 19, 2009 at 1:41 PM, topsecret09 (37.32) wrote:

   BENT.......What Pelosi should have responded to this moronic query was: "Where in the constitution? Article 1, sections 1 and 8, among others. Have you bothered to read them, you fatuous nutjob posing as a reporter?"   I have already read this,and I do not see,nor do I Interpret that the Federal Government has the power to force It's citizens to pay for something that they may OR maynot want. This Is referred to as "socialism" at It's core,and should be very alarming to all United States citizens....  What else do you think our government should force us to do ?  Why should I be forced to pay for something that I DO NOT WANT,OR NEED? I already have Insurace,and I do not need theirs,yet you feel that In your Interpretation of the constitution that they can force me to buy Insurance,and threaten me with jail time If I do not comply ? Let me know If you seriously think that the government has the POWER to do this,because If they do,we are In deep trouble with regards to this REPUBLIC that our founding fathers created for THE PEOPLES WELL BEING......  TS       http://www.examiner.com/examiner/x-27580-St-Louis-Conservative-Examiner~y2009m11d5-Another-democrat-scrambles-to-justify-the-constitutionality-of-the-health-care-bill 

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#41) On November 19, 2009 at 1:58 PM, TMFBent (99.82) wrote:

You'll have to try again, topsecret. The government can "force" you to do a lot of things you might not otherwise like to do. It can force you to drive the speed limit. It can force you to buy car insurance, fire insurance, flood insurance, and pay a registration fee for your dog. It can force you to pay taxes to support the costs of other legislative mandates and it can restrict the amount of porn (and the type) we get in our own homes. 

The constitution gives legislators the task of making these decisions our our behalf. If you don't like it, you get to change those individual decisions from within the system.

Claiming that they're not constitutional only shows that you don't understand the constitution. It's not my interpretation you take issue with. It's the established interpretation that has built this nation for a couple of centuries.

Sj

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#42) On November 19, 2009 at 2:00 PM, whereaminow (45.39) wrote:

Ya know, if you're going to be a Liberal, you really shouldn't be complaining when your benevolent overlords and technocrats make these decisions.  They'll be making a lot of them for us now (thanks for that by the way) and you're not going to like them all. That's just the way it goes.

David in Qatar

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#43) On November 19, 2009 at 2:01 PM, bigpeach (26.37) wrote:

topsecret, I've said this to you before but I'll say it again, you read too much right wing propaganda. Anyone who suggests Congress does not have the authority to enact a law simply because it is not explicitly granted authority to do so does not understand the Constitution or, more likely, is trying to manipulate your opinion.

Have you forgotten you're required by law to buy auto insurance? I don't recall any mention of cars in the Constitution. Perhaps you've submitted a legal challenge to the Constitutionality of that law.

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#44) On November 19, 2009 at 2:24 PM, topsecret09 (37.32) wrote:

  No,you will have to try again Bent,  CONGRESS HAS NEVER BEFORE REQUIRED ITS CITIZENS TO PURCHASE ANY GOOD OR SERVICE......     And I do understand the Constitution...   Legal Scholars are DIVIDED On this Issue.... A quote from the Congressional Budget office In 1994 stated that "A mandate requiring all Individuals to purchase health Insurance would be an UNPRECEDENTED FORM OF FEDERAL ACTION"...  http://www.washingtontimes.com/news/2009/oct/28/constitutionality-of-health-overhaul-questioned/    TS

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#45) On November 19, 2009 at 2:26 PM, ChrisGraley (29.95) wrote:

In topsecret's defense our own government has been trampling both the constitution and the wishes of our forefathers for almost a century. (both liberals and conservatives)

We technically should be on the gold standard and without the Fed right now, among other things.

Just because the government gets away with breaking the law doesn't mean they didn't break it. That is fortunate for GM's union and unfortunate for GM's bondholders.

Bent A note, however. None of the plans out there now remove your "right" to choose what you spend on health care. They don't eliminate private insurance nor high dedictible plans.

True Bent, but what they will do is insure that those plans fade away as more people flock the subsidized option that promises everything to everybody. By the time everyone realizes that we won't be able to pay for it, the other plans will all be gone and even if they tried to restart later, the government won't allow people to leave at the point that it's another government ponzi scheme. It will become just like social security. They will keep you in a program that doesn't work for your benefit to prolong insolvency.

Big government always equals big problems. Always!

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#46) On November 19, 2009 at 2:29 PM, whereaminow (45.39) wrote:

I suppose if you don't like the decisions that these panels make you can always vote them out of office.  Oh wait, that's right, we don't get to vote for these people.  Hmmmmmm.....

David in Qatar

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#47) On November 19, 2009 at 2:33 PM, ozzfan1317 (82.26) wrote:

Excellent points +1 Rec..Wait most of us just agreed on something how can that be?..lol

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#48) On November 19, 2009 at 2:48 PM, TMFBent (99.82) wrote:

What panels are you talking about, David? And if you don't like decisions on your health care being made for you by others, you shouldn't have any insurance at all, because those companies are filled with people whose job it is to ration health care for you. You don't get to vote for anyone on those panels either. But you can vote with your wallet by buying another plan or opting out, paying for the consequences of your decision on your own.

None of that will change with the plans before Congress now. The flaws with them are not too much government intervention. The flaws are government entering into an irrational market and promising to make the same mistakes it's already making.

Top secret, please don't be offended that I'll no longer respond to you. If you want to post blatant falsehoods, do it on your own blog. The folks posting here who are required to buy insurance for any number of items know that the requirement to buy health insurance is no real novelty.

Moreover, if you paid closer attention to the text of the latest bills, you'd probably note that Pelosi took the teeth out of any real punishment for those who don't buy insurance. (At least last time I checked.)

So, if you don't want to have to buy insurance, Nancy Pelosi is your new best friend. (Didn't see that one coming, did you?)

But that's the last you'll get from me.

Sj

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#49) On November 19, 2009 at 3:07 PM, Turfscape (39.47) wrote:

ChrisGraley wrote:
"The point is that right now I do get to make the decisions because it is my money (to some extent) and I believe that I have a right to control my own destiny."

And the Sec. of HHS wanted to make sure that you (or your loved ones) continue to get to make the decision...that your insurer couldn't now deny access to mammograms due to the findings of the study.

And to the author...how many oncologists were part of the study?

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#50) On November 19, 2009 at 3:20 PM, TMFBent (99.82) wrote:

I couldn't tell you. I also wonder why you think it would matter.

If you can't find oncologists on both sides of the controversy, you're probably not using the Google well enough.

Sj

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#51) On November 19, 2009 at 3:27 PM, topsecret09 (37.32) wrote:

    "you. If you want to post blatant falsehoods, do it on your own blog."    What I have said Is the actual TRUTH,and I have backed It up with links that Include The Congressional Budget Office,and they are Non-Partisan. I believe that your basic arguement Is not backed up by anything except your perceptions. If you truly believe that Individual States mandates somehow Intertwine with the Federal governments,you are mistaken. No need to respond,just post the links to the Information that you feel Is relevant to the discusion. I am not here to win an arguement,I am here because as a United States citizen,I am extremely concerned that our government Is overreaching their authority on this Issue, as well as a host of other Issues that should concern all Americans. All of America should be extremely concerned about the government telling Its citizens "do this or there will be consequences".....    By the way,I respect your opinions,and I hope that we can get beyond all of the rhetoric and work together to make sure that our Individual freedoms will survive the test of time for future generations to enjoy. All the best... TS

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#52) On November 19, 2009 at 3:36 PM, Turfscape (39.47) wrote:

TMFBent wrote:
"I couldn't tell you. I also wonder why you think it would matter."

There were no oncologists in on the study. And, if you're studying cancer...probably a good idea to have cancer experts in on the study. If you're trying to fix the economy, probably a good idea to get input from economists. If you're trying to fix your toilet, probably shouldn't rely on advice from an auto mechanic.

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#53) On November 19, 2009 at 4:54 PM, vriguy (81.27) wrote:

He who pays the piper calls the tune - if the taxpayer is paying, (s)he would rationally want the most bang for their buck, and that means not routinely doing mammograms on 40 year olds unless they have some risk factors for breast cancer. For those screaming hysterically that 40 year olds must be screened at someone else's expense, I ask - why aren't you screening 38 year olds? or 30 year olds?  There are women who get breast cancer at 31 that might have been caught by mammography at 30. No magical change happens the day you turn 40, or 50. The reason we're not screening 38 year olds routinely is that another panel, some years ago, came to the conclusion that the benefits outweighed risks if we routinely screened women after age 40.  More evidence has come in, and recommendations have been revised.  The bottom line is we've got to go with the best evidence available.

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#54) On November 19, 2009 at 4:55 PM, vriguy (81.27) wrote:

He who pays the piper calls the tune - if the taxpayer is paying, (s)he would rationally want the most bang for their buck, and that means not routinely doing mammograms on 40 year olds unless they have some risk factors for breast cancer. For those screaming hysterically that 40 year olds must be screened at someone else's expense, I ask - why aren't you screening 38 year olds? or 30 year olds?  There are women who get breast cancer at 31 that might have been caught by mammography at 30. No magical change happens the day you turn 40, or 50. The reason we're not screening 38 year olds routinely is that another panel, some years ago, came to the conclusion that the benefits outweighed risks if we routinely screened women after age 40.  More evidence has come in, and recommendations have been revised.  The bottom line is we've got to go with the best evidence available.

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#55) On November 19, 2009 at 5:21 PM, TMFBent (99.82) wrote:

There were no oncologists in on the study. And, if you're studying cancer...probably a good idea to have cancer experts in on the study. If you're trying to fix the economy, probably a good idea to get input from economists. If you're trying to fix your toilet, probably shouldn't rely on advice from an auto mechanic.

Attractive argument, but pretty faulty, IMO. If you want to know if Congress is effective, do you need Congressmen to tell you? If you want to know if the police are doing effective patrolling, do you have them tell you?

If you want to understand the data and the outcomes, you don't need to ask oncologists -- you want statisticians and proper methods. If you want to know whether or not our policies on mammogram screening are effective, you're probably better off asking economists than oncologists. In fact, you may want to eliminate practicing oncologists entirely, as they are what you would call non-disinterested parties, from an economic standpoint.

Dismissing a study because you don't like the job titles of the people who crunched the data is illogical, and just a variation of the old ad hominum attack.

You want to argue the data and conclusions, start there.

But if you do, you'll be missing the point of this post entirely. It's beyond one study. It's about people who cannot ever accept that health care is a scarce resource and that we can't give everyone everything. No matter what the evidence, some people will find ways to argue that its not fair to deny someone some standard of care, or tests, regardless of whether or not it makes economic sense in the macro or microeconomic scale.

Until this notion changes, there is no hope for any heath care reform in this country.

I challenge those who believe that no price is too high to pay for saving a single life to explain how we pay for that standard.

Sj

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#56) On November 19, 2009 at 6:25 PM, Option1307 (29.92) wrote:

Everyone can't have everything. It's that simple.

I challenge those who believe that no price is too high to pay for saving a single life to explain how we pay for that standard.

This basic thought sums up the entire problem of the healthcare debate/reform. People are unwilling to discuss the true reality of the situation, especially politicians b/c it's obviously suicide for them. Nonetheless, it needs to be talked about. We can sugar coat it all we want, but in the end it all comes back to what you said, Everyone can't have everything.

I really get tired of all the crap out their from mainstream right/left wingers. Ya they make a few reasonable arguments, but neither of them address the real issue. Typical politics...

Awesome post!

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#57) On November 19, 2009 at 6:42 PM, ChrisGraley (29.95) wrote:

Everyone can't have everything. It's that simple.

I challenge those who believe that no price is too high to pay for saving a single life to explain how we pay for that standard.

That is exactly why politicians can't possibly be in control of health care. I am a healthy individual, but I'd rather die than have my family to be in perpetual debt for a false hope.

If we get government healthcare I'll be a vegatable strapped to a machine that politicians point at to prove they they will go the extra mile to get everyone the most healthcare.

This isn't about helping people, it's about making people more dependent on your party.

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#58) On November 19, 2009 at 7:33 PM, RainierMan (75.28) wrote:

Wow! A balanced blog that touches the political realm.

Americans want access to ALL of the health care universe. And if that isn't provided, someone, somewhere is going to die, because that's just inevitably going to happen after X millions of cases. At some point, the down side of balancing cost and benefit is going to rear it's ugly head.

And when that happens, should it be under a reformed health care system, guess who is going to get the blame? The government. The government will have "killed" it's first person. And it won't matter one bit how many people who can finally access health care were saved. The ONLY thing that will matter is that person who just died because he/she didn't get the specific test/treatment that could have changed that.

 

 

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#59) On November 19, 2009 at 8:03 PM, TMFBent (99.82) wrote:

If we get government healthcare I'll be a vegatable strapped to a machine that politicians point at to prove they they will go the extra mile to get everyone the most healthcare.

Or to score points with a portion of the electorate by pretending to try to score points with the man upstairs by some twisted argument about the sanctity of life (no matter what that life might be like.) Remember that poor woman in Florida. And all the Republicans who lined up to try and take away the husband's decision.

By the way, where was the "hands off my healthcare" crowd then?

Sj

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#60) On November 19, 2009 at 9:05 PM, SnapDave (61.41) wrote:

Seth None of the plans out there now remove your "right" to choose what you spend on health care. They don't eliminate private insurance nor high dedictible plans.

But they do.  By taking tax money from all taxpayers, esp. the 'rich' and those with 'Cadillac plans' to pay for it you soon force out private ins.  If I'm paying for my private plan and helping pay for your public plan the private won't be able to complete.  

Higher deductibles and dropping coverage for small things are definitely part of the solution.  

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#61) On November 19, 2009 at 10:10 PM, whereaminow (45.39) wrote:

Socialism, liberalism, progressivism (whatever they are calling it these days) is just table talk for the Democrats - something they promise their constituents but also something they have no intention of actually ever delivering.

Of course they promise to get around to it, once they rout the Republicans, but you and I know they never will. Instead they dance behind the scenes with big business, just like the Republicans do, and the electorate pisses and moans but can't do anything about it. They're too busy drinking the "good government" Kool-Aid.

This health care bill is brought to you by the same exact people that delivered the current mess - the politicians and lobbyists, who mandated America's current fiasco in 1973. 36 years later, Americans are still under the same delusional belief that these people will suddenly work in the public's interests. ROFL.

Don't sweat it though, TMFBent. Republicans use the "free market" talk to distract their voting base in the same way, promising to deliver it once all the terrorists and Democrats are finally beaten. I'm not holding my breath.

David in Qatar

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#62) On November 19, 2009 at 10:16 PM, whereaminow (45.39) wrote:

TMFBent,

I know it's confusing, but you're not arguing with Republicans anymore. ChrisGraley, TopSecret, myself, Dare, and dozens of people who read our blogs and debate with you are not Republicans.

For the most part, even though we get referred to as "right wingers", we are further to the Left than the Democrats.

Anti-Republican arguments are meaningless here. I couldn't give two sh*ts what Newt Gingrich, Bill O'Reilly, Rush, Palin, or Huckabee think.

David in Qatar

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#63) On November 19, 2009 at 10:27 PM, grassman101 (< 20) wrote:

Bent,

You need to revisit the facts on the woman from Florida before you toss that out there as an example.

Bill

 

 

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#64) On November 19, 2009 at 10:35 PM, DaretothREdux (41.72) wrote:

TMFBent,

How "republican" does this sound to you? That's about how much I think our current gov't should be involved in healthcare...maybe less...only problem is that they are already too involved and the undoing of that involvement is extremely difficult, especially when the "liberals" have people believing the government is going to lower costs and provide "free" healthcare to the poor unfortunate millions of uninsured....or tax them until they buy some...

Dare

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#65) On November 20, 2009 at 8:51 AM, TMFBent (99.82) wrote:

I know I'm on the right track when people try to decide that I'm a democrat (or republican). No one can admit when the politicians in their fave party behave like morons -- one of the reasons I don't adhere to a party.

Those who think I'm a democrat could take a look at another post or two on this blog.

The bottom line remains the same: No one in government is addressing the real problem. And the real problem isn't "freedom," too much or too little. It's not a right to healthcare or a right to life.

The problem is the greed of every individual operating in a system where that greed is only allowed to push prices one way.

Someone needs to ration healthcare. Insurance has done a rotten job of it. Government has done a rotten job of it. People have done a rotten job of it for themselves.

I don't care, really, who does the rationing, but it has to be done. Trouble is, no one wants to admit it, and therefore they contort themselves into all kinds of ridiculous arguments to try and prove that [pick the thing you don't like here] is the problem and that if left to [pick the thing you do like here] it would all be fixed.

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#66) On November 20, 2009 at 12:27 PM, Turfscape (39.47) wrote:

TMFBent wrote:
"If you want to understand the data and the outcomes, you don't need to ask oncologists -- you want statisticians and proper methods. If you want to know whether or not our policies on mammogram screening are effective, you're probably better off asking economists than oncologists."

Uh, no. If I have a medical concern, I'm going to look for my doctor's opinion...not that of a statistician. Interestingly, there's a study out today recommending the ending of annual PAP tests for women under 21. It also recommends moving to PAP tests bi-annually instead of annually for those women, unless there is an anomaly. I won't question this decision...but it was proposed by the American College of Obstetrics and Gynecology. You know, people who engage in the profession and are true subject matter experts. (link to story)

TMFBent wrote
"By the way, where was the "hands off my healthcare" crowd then?"

I'm wodering the same thing now? A government advisory board is looking to make a decision that has historically been between a woman and her doctor, but where's the outrage and hysteria about "death panels" sentencing women to die of breast cancer?

 

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