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  • Morning Bell: Nailing Down Daschle's Direction on Health Care

    Previewing the Senate’s confirmation hearing for President-elect Barack Obama secretary of Health and Human Services appointee Tom Daschle, the New York Times predicts: “Daschle to Face Tough Questions on Competition in Health Insurance.” And we certainly do hope that Senators press Daschle hard on his vision for a government run health plan that will ‘compete’ with private health care options. As we have argued before, just as the Boston Red Sox would not trust George Steinbrenner to write the rules and hire the umpires for Major League baseball, Americans should not trust Congress to both set the rules for health care competition and then also ‘compete’. If you think a government entrant into the marketplace will not inevitably turn into a monopolistic financial disaster, then we’ve got two failed mortgage financing giants we’d like to sell you.

    But the creation of a government run health plan is just one of many troublesome view held by Daschle. His book, Critical: What We Can Do About the Health-Care Crisis is an excellent source for possible questions and issues to be raised at this hearing. These key questions include:

    The Future of the Doctor-Patient Relationship: On page 199 of his book, in discussing the powers of the proposed Federal Health Board, Daschle writes, “Doctors and patients might resent any encroachment on their ability to choose certain treatments, even if they are expensive or ineffective compared to the alternatives. Some insurers might object to new rules that restrict their coverage decisions.” Daschle ought to explain why his vision for reform of America’s health care system will deny doctors the right to prescribe, and patients the right to choose, medical treatments or procedures that they deem best for their particular medical condition when a appointed government panel deems them to be too “expensive”.

    Recourse for Patients Denied Care: On page 200 of his book, once again discussing the powers of the proposed Federal Health Board and its appointees, Daschle writes, “When the Federal Reserve Board sets interest rates, it affects people’s money. But when the Federal Health Board makes coverage decisions, it will affect people’s lives.” Then, on page 201, discussing the power of the board members, Daschle adds, “They will be political appointees, chosen by the president and confirmed by the Senate. The board will derive its authority from Congress, and Congress can dismantle it whenever it wants. Congress will have the power to overturn a board decision or remove a board member for good cause, although I hope it will use this power sparingly, if ever.” If an individual patient were denied a medical treatment, procedure or drug as a result of a decision of the board, what would be their recourse short of an act of Congress? Would there be an appeals process, like Medicare, or access to the federal courts, or both?

    The Government Run Plan: On page 171 of his book, Daschle writes, “The Federal Health Board would also work with Medicare to develop a public insurance option for the (national) pool, designing it to compete with the private health insurance plans on the FEHBP menu.” Based on the robust findings in the professional literature, the creation or expansion of public health programs invariably “crowds out” private health insurance coverage, particularly as employers drop health coverage and enroll their employees in government programs. How can Daschle guarantee Obama’s promise to Americans that if they are enrolled in private health plans, nothing would change for them?

    The British NICE Precedent: On page 127 of his book, Daschle writes, “In other countries, national health boards have helped to ensure quality and rein in costs in the face of these challenges. In Great Britain, for example, the National Institute for Health and Clinical Excellence (NICE), which is part of the National Health Service (NHS), is the single entity responsible for providing guidance on the use of new and existing drugs, treatments, and procedures.” If that British agency determines that a treatment is cost effective, it must then be available within the NHS, but it also denies reimbursement for treatments, making them practically unavailable for patients. Based on NICE’s record, does Daschle really want to see similar results for doctors and patients in the United States?

    Tax Policy: Senator Max Baucus (D-MT), chairman of the Senate Finance Committee, has said that Congress should re-examine the federal tax treatment of health insurance, noting that there is a strong, bipartisan consensus among economists and policymakers that the existing tax policy governing health insurance is both unfair and economically efficient. Does Daschle believe that this growing consensus is sound and that persons who do not or cannot get health insurance at work should be penalized by the tax code if they buy it on their own?

    There is a clear consensus in the country that America’s current health care system, under which the government already purchases 46% of all medical care, must be changed. Where there is sharp disagreement is over what direction that change should take. Those means should not deny Americans the ability to maintain private health insurance that they want; the benefits, medical treatments, and procedures that they want; or the relationship with the physician that they value. The answer is less socialized medicine, not more.

    Quick Hits:

    Posted in Ongoing Priorities [slideshow_deploy]

    17 Responses to Morning Bell: Nailing Down Daschle's Direction on Health Care

    1. J.C. Hughes, Texas says:

      I could not agree more with your article "Nailing Down Daschle’s Direction on Health Care". As a nurse, I've seen the need for avilabilty fine tuning of our current system. My greatest concern is a socialized sledge hammer that will leave us with a junked system.

    2. D. Lars says:

      "…creation or expansion of public health programs invariably “crowds out” private health insurance coverage…" What part of this statement is completely lost on politicians and bureaucrats? Once Govt sticks its nose in the door and decides to “compete” with private enterprises, competition and the marketplace is destroyed. It’s similar to the situation when small businesses are displaced due to the big-box stores. Then the Govt experts harrumph about how prices are out of control—hello Govt, your pricing mechanisms are driving the train; not the market and competition.

      Besides anyone who wants more Govt services must be in the dark about the nature of bureaucracies. Govt bureaucracies report to other bureaucrats, policies, procedures, laws and politicians. They don’t answer to the public. That’s right; you the customer don’t affect their success or failure. The staff reports to their bosses and their bosses are judged on how well they followed the policies, procedures, laws and politicians. That’s what is put on their performance reports and how they are inspected by the Inspector Generals. Pleasing you as a customer has no impact on the individual bureaucrat or the agency. Bureaucracies are not held accountable by the marketplace, competition, revenue generation, customer satisfaction…

      Want to improve health care, et al? Keep Govt out of services and let the markets and competition provide our services. We still need Govt oversight to regulate illegal, unsafe, and unethical practices, just don’t have Govt as a participant of services.

    3. Eduardo "Mr. Ed says:

      The main problem our Nation faces is the U. S. Congress's waste, pork and entitlements. Putting a stop to our politicians shameful stewarship of our tax money is the main priority. No more taxes. No more bailouts. No more stimulus. No more pork & entitlements. Also, failing companies must change their business plans or simply go bankrupt. The question I pose is this: How can we – the citizenry – do it?

    4. Dave McDuffie, lagun says:

      Well the American public is stupid enough, yes STUPID enough, to allow these crooks in congress to continue to steal our money to pay into the social security system and at the same time, giving all the money away to those who never paid a dime into it and telling us its going to be bankrupt soon(soon mu a–, it already is!)so don't expect any benefits to be paid. Now the stupidity continues so that eventually we will be paying billions, excuse me, they will be stealing billions of our tax dollars to ultimately tell us that system is also bankrupt and not to expect any benefits. This current crop of get rich quick scam artists in all of government needs to be put behind bars for crimes against the people and that needs to happen NOW before we have blood running in the streets. At the current pace, losing millions of jobs in the private sector will completely collapse this entire country! And OBAMA will lead the charge because this simple minded person who has NEVER accomplished ANYTHING on his own does not understand this simple truth: The government HAS NO MONEY! The government TAKES IT BY FORCE FROM THOSE WHO ACTUALLY WORK FOR IT!!! It is completely IMPOSSIBLE to grow the economy with GOVERNMENT JOBS…it takes you in the OPPOSITE DIRECTION..DUHHHHHH! Government jobs COST, they do not PAY!

    5. Duke Lynch CA says:

      When I was a kid family Doctors made house calls…then came insurance…Doctors organized into clinics and the sick patient had to got to waiting rooms full od other sick people and showed insurance cards,,,,,,or……….govenment cards. Everything seemed to work until greed came into being and now Doctors and the sick are at the mercy of the insurance and government bimbos.

    6. mike hutchings texas says:

      In world war two german forces in the ukraine had a soviet position on and under a hill in the steepe that they could not dislodge with tanks,bombs and artillery.frustration called for a change in tactics.the line was called in.

      sargents and corporals and enlisted men tackled the problem.tired of losses no doubt.they set up gun positions face to face with enemy strong points and routed them out with little loss and a bag of two thousand prisners.

      do we not have capable people in the medical field that can come up with a better plan than staff to be set above them with nothing to thier credit but politics.in the case of the military staff they trusted the solution people who were on the line with their own lives as we are at some point when a doctor makes a medical judgement and not one based in politics there is room for oversight but it makes as much sense to trust energy production to someone with hostility to the industry as it does to turn medicine over to politicians,

    7. LVKen7@Gmail.com - says:

      The Cs are circling the wagons

      they have hooked up with

      Rush and Hannity

      in Askheritage.org.

      I heard about it on Rush's Radio HATE show.

      But,

      he forgot to say

      it cost $25.00 to join.

      KJ

    8. Howard Waltner says:

      If Obama thinks we are going to stand for him pushing through a Government-controlled health plan – and demands that we all participate in this, he is going to have a battle royal such as this country has never seen. I am so sick of the Government trying to control every aspect of the private sector and dictate how we live our lives. They meed to back off before there is a revolution in this country that will remove them all from Our Capitol!

    9. Delfin J Beltran MD, says:

      Any person with a sense of self preservation needs to remember some basic concepts regarding Government controlled healthcare.

      1- In every encounter with the government regarding the care of patients under their plans I have been told that since they pay the bills they will determine he my role and compensation – The principle is: He who pays the Piper calls the tune.

      2_ To date since the successfull implemetation of socialized medical care for the social class of persons over age 65 has been the determinant factor causing the massive increase of medical care cost in both private and government care

      3- The physicians no longer have a direct physician-patient contract for care. Either the government or the insuror is the contractor and supplier of patients to the professional component.

      4- The communication system that maintains the professional status of physicians has been destroyed. Medical staffs are no longer independent, self-governing organizations of licensed professionals that oontrol and have the responsibility for the quality of patient care in the hospital. That concept if medical staffs has been subrogated to the position of an administrative MD who represents the powerless medical staff at the executive committee level and derives the power of office from the board of directors, not the physicians.

      5- Recall Dr.Harry Beecher, Dean of Harvard Medical School. who in a 1959 JAMA article clearly stated that the morally repugnant behavior of the German admiminstration could not have occurred had not the medical profession subjugated itself to the will of the socialist political domination. Remember that NAZI party was the National Socialist Party, a left wing, not right wing political movement.

      6- As the Medical Director of the Stanford ICU 1968 to 1971 I had the privelege of introducing a scientifically valid testing for brain death of the heart donors for the first cardiac transplants at that hospital. Under proposed socialization of our healthcare life and death decisions will be made in Washington, a great distance from the front lines of medical care that are essential to your life when that time comes in the life of each of us. Government officials whose primary concern is the cost of the class, patients, rather than the welfare and healthcare of the individual patient to whom their regulations apply. Your assigned physician will no longer be an advocate fou your good health, but rather and agent of the government assigned the responsibility to save money for the government. Washington has already threatened that hospital acquired infections and DVT are a class of diagnoses that represent physician failures and will not be reimbursed. Where the government agents derived this power to practice the validity of their 'class diagnoses' is beyond any moral or professional medical power and is the road to the cheapest form of therapy, namely death to the patient.

    10. David Barth, Jupiter says:

      As a terminal leukemia patient currently undergoing chemo treatments, because of my age and the cost of the treatments a Government Board would refuse me treatment and let me die. Is this what America is about?!

      I have private insurance and I want to keep it that way. I am a Great Depression Baby from the Greatest Generation as well as a military war veteran and I assure the current narcissist, entitlement-addicted generation that they will regret the day they allow the politicians control our medical and health care.

      As an aside, has anyone told the trial lawyers that they cannot sue for Medical Malpractice under Socialized Medicine? That should get the ire up to the Obama/Hillary Administration they so espoused.

    11. frankz, brewster, ny says:

      We continue to "overhaul/change social security/medicare; we need to fine tune it, erase the fraud and duplication and ensure it's there for the U.S.citizens that paid the tab over the last 30 plus years. If you want first hand knowledge, please let me know as I visit nursing homes every week and have for many years. It's not a simple process, but it can be fine tuned over time to be the most superior system ever imposed on people. Image, people invest for 50 years and should get what they were forced to pay for.

    12. Cheryl, Minneapolis says:

      I work in the healthcare system and let me say one thing. Medicare is "government healthcare" and it is a broken inadequate plan that does a disservice to everyone involved including the patient.It is a drain on healthcare and prevents efficient systems from being implemented. Often we only get paid 30% of what is charged, forcing us to set charges higher than would be in a free market system to try to recover costs. We still write off millions every year. This hurts everyone in too many ways to list. Not to mention the government induced red tape that occupies health professionals daily, taking time away from providing care and frustrating patients. Insurance companies conveniently and generally follow Medicare rules for reimbursement so you can't win there either. Yes those of us in healthcare can fix this…the answer is the free market like D. Lars suggests, not more government healthcare. Hospitals will go out of business and care will be rationed with socialized medicine. The biggest lie of all is that Americans don't have access to healthcare. Everyone can access healthcare. However, none (most anyway) of us can get any procedure we want without costs nor should we. With the free market model, healthcare will be competitive, prices will go down, costs will decrease, processes will be leaner and all will benefit.

    13. Tom Witter, Elm Grov says:

      I'm in the health care business, as well. I own a software company that provides administrative capabilities to Health Plans and Third Party Administrators. I work on both the "insured" side and the "self-insured" side of the business.

      When evaluating the high costs of health care in the US, there are a two undeniable truths that must be considered:

      1. We have the best health care delivery system and services in the world, bar none

      2. When the government runs a program, the service is worse and the cost is higher than if a private firm performed the same functions. THERE IS NO EXCEPTION TO THIS RULE.

      When you examine the contributing factors to what drives the cost of health care up, the government is right in the middle of most of them.

      Government Medicare and Medicaid programs pay providers an arbitrary rate (determined by them) that is far below the market value, causing cost shifting to non-government citizens' care resulting in higher costs to insurers and plans.

      HIPAA regulations introduced by the government – Clinton administration – added an unbelievable cost burden to everyone in the system from doctors to insurers to service providers. Of course, this had to be passed on to consumers.

      Government mandates in coverages at both the state and federal level drive costs up with the same result.

      Government programs like WHEFA Bonding in Wisconsin give providers and hospitals low cost loans to proliferate their facilities, often without adequate demand. This results in higher prices for the services in order to justify the expense.

      Generally, politicians have only one concern – preserving their political future – so all of the government entitlement programs exist because individual citizens with an "entitlement mentality" and "no skin in the game" complain to them.

      Frivolous lawsuits against doctors and huge settlements from entitlement-minded jurors have driven malpractice insurance costs out of sight and, guess what…driving up the cost of services.

      It's not the insurance companies! The solution begins with individuals taking responsibility for their own care. Consumer-driven health care in the private market is the solution. However, in order for this to be effective, information is the key. Be accountable!

      If you're interested, visit the blog I just started at http://americanhealthcarereporter.blogspot.com. I'll link to this blog, as well.

    14. Bonnie Carniello Mar says:

      How many people around Obama owe or owed back taxes when he selected them for any position?

      Can all of the elected officials stop spending money on the tax payers backs and the next 4 generations. It really isn't monopoly money!

    15. Gene of CA says:

      Thanks to socialized medicine in England my aunt died of cirvical cancer last year – waiting for her turn to be treated. Waiting for some bureaucrat to decide what was best for her.
      All of the problems that we face today were brought about by bureaucrats. Why on earth would anyone believe that a bureaucrat would be able to solve these problems? Why do we give them power over our lives?

    16. Pingback: Obama becomes a lame duck tomorrow « Standing Pat

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