Posts Tagged ‘Health’

Live Analysis of President Obama’s Health Care Speech to Congress

September 9, 2009

I know it’s been a while since I’ve done a blog post (other than the one I did yesterday), but I figured this was an important issue to talk about, and I’ll probably be writing a column on health care sometime this week, so this will help me get some ideas down a little early.

President Obama is about to give  a speech to a joint session of Congress, and I’ll be giving my live analysis of his speech.  And this is live, so excuse any typos – I’m not always great at typing quickly.

Speaker of the House Nancy Pelosi has just gaveled the session into order, so we’ll begin in about 10 minutes here.

The President’s speech is expected to last about 45 minutes (not including applause), so I’m guessing that it will run close to an hour (maybe a little over) when it’s all done.

Speaker Pelosi has now called the session to order – Vice President Joe Biden by her side.

The Escort Committee is now leaving to follow behind President Obama when he enters the chamber.

Michelle Obama is now arriving.  The Cabinet is now coming into the chamber.

President Obama is now coming into the chamber – and he’s getting a lot of applause (as every President does during these joint sessions).

He’s now up to the podium – Speaker Pelosi is trying to bring the chamber to order.  She is now introducing President Obama.

He’s talking about the last time he spoke here – that it was during the worst economic situation we’ve faced since the Great Depression.  “We are by no means out of the woods … a full recovery is still months away.”  He’s saying that he won’t let up until “those who seek jobs can find them.”

Wow – Hillary Clinton looks out-of-place – she’s wearing this red suit and she’s surrounded by men in black suits.

President Obama is thanking Congress for their help and support in trying to fix America’s economy.  He’s talking about building a future for America, and that health care is central to that future.

“I am not the first President to take up that cause, but I am determined to be the last.”  It’s a nice quote, but there’s always going to have to be reform – things change – nothing will ever be perfect.

He’s talking about Teddy Roosevelt talking about health care reform, and Representative John Dingell (D-MI) introducing a bill every session to reform health care.

Talking about the hardships facing those who are uninsured – not those on welfare, but mostly the middle class.  He’s talking about people being denied insurance because of previous conditions.  “We are the only democracy … the only wealthy nation who allows such hardship for its people.”  But we’re also the democracy who other countries turn to for certain health care needs (such as Canadians needing some quick emergency treatments).

Talking about insurance companies dropping patients in the middle of treatment for bogus reasons such as having acne and not claiming it – and I’ll agree with him here – that’s a problem that SHOULD be addressed.

Talking about insurance premiums going up, and leading to businesses not being able to open/survive because of health care costs.

It’s “placing an unsustainable burden on taxpayers. … We will eventually be spending more on Medicare and Medicaid than every other program combined.”  Again – he’s right here – Medicare/Medicaid costs are getting out of control – it’s just the solution where I disagree with him.

Talking about a single payer system like Canada’s or a plan that individuals should buy their own health care, but both of these are radical shifts that would disrupt the health care system.  He’s saying we should use what works as a template and fix the problems in our current system, rather than switch to a Canadian-style system or a completely individual style system.

He’s now talking about the 5 committees coming up with health care bills in Congress – an amount of reform that has been unprecedented in history – and again – this is a good thing – if we have multiple ideas, we have more to choose from and more discussion going around.

Now he’s talking about opponents to reform using scare tactics and just trying to score political points.  “The time for bickering is over.  The time for games has passed.”  Games and bickering are part of the American political system – it’s a sad fact, but it’s true.  And both parties do it, but getting into a “Well the other party did __________” kind of mentality is bad for America.

“If you already have insurance … nothing in this plan will require you to change what you have. … What this plan will do is make this insurance that you have work better for you.”  It’ll make it illegal for insurance companies to deny you based on a preexisting condition.  And that got a LOT of applause.  It will be illegal for them to drop you when you get sick.

“No one should go broke because they get sick. … Insurance companies will be required … to cover routine check ups … and preventative care. … It saves money and it saves lives.”  And that was all for people who already have insurance.

For those who don’t, this plan will give you an opportunity to get quality insurance.  “We’ll do this by creating a new business exchange.”  Insurance companies will want this because it gives them more customers.

And for those who still can’t afford insurance, tax credits will be provided.  The exchange will take effect in 4 years.

He’s talking about immediate relief for those who get sick before then, citing a plan that Senator McCain proposed during the plan during the 2008 campaign – and Senator McCain just got a huge grin on his face.

He’s saying that some people may not want to pay for insurance, but when they get sick, we wind up paying for their health care when they wind up in the hospital.  “Under my plan, people will be required to carry basic health insurance” just like states require people to have basic auto insurance.

And this is where I disagree with the President.  Personally, I don’t think we should be forcing people to buy insurance; however, I also don’t think that we should then be paying for their hospital visits.  If someone decides not to get insurance, and they get sick, then we shouldn’t be footing the bill – they should just have to pay for treatment themselves or not get it.

Now, moving on to “key controversies that are still out there:”

  • Saying that there won’t be plans to try to kill off the elderly who are sick.
  • No money will go toward illegal immigrants. – and somebody just shouted “Lie!” and Speaker Pelosi gave him a stare of death – whoever it was, that was pretty unprofessional and immature.
  • No money will go toward funding abortions.
  • This will not be a takeover of the entire health care system.

These are all good points, and I’d encourage EVERYBODY to read the bill that finally gets introduced instead of just listening to either the Democrats’ talking points or the Republicans’ talking points.

“Consumers do better when there’s choice and competition.”  And he’s absolutely right about that – but instead of setting up a government program to do this, we should open insurance markets to cross state lines, so that companies can compete nationwide, adding more competition all over the nation.

He’s saying that he doesn’t want to drive insurance companies out of business, just hold them accountable.

He’s saying that he would like a non-profit public option (which that surprised me that he still pushed for that – I figured that he wasn’t going to try to push that tonight).  It would be an option for those who don’t have insurance, and people wouldn’t be forced to chose it.  He estimates that less than 5% of Americans would sign up.  He’s saying that this public option wouldn’t be funded by the government, but would have to be self sufficient.

But what would happen if it stopped being self sufficient?  Would it essentially turn into a Fannie Mae or Freddie Mac?

He’s saying that some are suggesting that the public option only go into effect where insurance companies aren’t competing well, or that we have a private co-op instead.  Saying that he won’t back down from giving a choice to people who can’t afford health care.

And the screen just panned over to the Republican section and they really do not look happy about this.

“Now he’s talking about how we’ll pay for the plan – “I will not sign a plan that adds one dime to our deficit – either now, or in the future. … Period.”  He’s saying that in his plan, there will be a section that will require spending cuts if the means of saving money aren’t there.  He’s now talking about the past administration making a mistake in passing tax cuts that we couldn’t afford as well as the Iraq War.

And while he does have an excellent point with the Iraq War part (which is a whole separate issue), I don’t think that that jab at the Bush Administration is going to help win any Republicans over – and with Senator Kennedy gone, they’re going to need an additional Republican vote in the Senate.  That was a bad strategic move on the President’s part.

Talking about ensuring that Medicare will be there for future generations.  Saying that seniors pay too much out-of-pocket for prescription drugs.  Saying not to pay attention to “scary stories that your benefits will be cut.”  GOP members don’t look happy.  “I will protect Medicare.”

“Making [Medicare] more efficient will [help make] the entire system more efficient.”  Saying that if we reduce waste in Medicare and Medicaid, that will pay for his plan.  Well why don’t we just reduce waste in Medicare and Medicaid anyway!  Why do you need to add one “good” thing to get rid of one bad thing?  Why not just cut waste out of M&M whether or not the other health care reforms pass or not.

Talking about malpractice reform bringing down costs of health care – and all the GOP members stood up and started cheering – even Biden stood up for that one.  Saying that we need to put safety first and let doctors focus on practicing medicine.  Saying that the Bush Administration wanted to test some of these ideas in individual states, and he likes that plan too.  So now he’s playing to the Republican side a bit – which is good because he’s going to need to do that if he wants this to pass the Senate.

Now talking about it’ll cost $900 billion over the next 10 years, but that’s less than the Iraq War…and I think he said something about the Bush tax cuts – I didn’t catch it.  Whatever it was, the Dems liked it, but the Repubs looked pretty pissed off – Rep. Thad McCotter (R-MI) really didn’t like whatever was said.

Saying he won’t stand by as the special interest groups fight to keep things the way they are.  “I will not accept the status quo as the solution.”  And he’s right – we DO need reform – I just disagree with him on the type of reform we need.

Talking about reforms leading to saving lives.

“We cannot fail … there are too many Americans counting on us to succeed.”

Talking about the late Senator Kennedy (D-MA) on his death bed talking about this year being the year that health care reform will be passed.

Health care reform has been a source of “rigorous and intense debate”.

Obama’s talking about Senators Hatch (R-UT) and McCain (R-AZ) and Grassley (R-IA) working with Senator Kennedy.  That his p”assion was born out of his own experience … having 2 children stricken with cancer.”  He’s saying that “concern for others … is not a partisan” issue.  “We are all in this together, and when fortune turns against us, others are there to give us a helping hand. … Sometimes government has to step in.”

Saying that Republicans and Democrats joined together in 1965 when they created Medicare.

“When any efforts to help people in need are attacked as unAmerican … and we can no longer engage in a civil conversation” … I missed that last part.  Whatever his point was (I’m sure it was something about engaging in civil debate) – I agree here – we need to discuss it, not try to drown one side out.

“I still believe we can act when it’s hard.”  Saying we need to have “civility” and not gridlock the process but make progress.

“I still believe we can do great things, and that here and now we will meet history’s test.  Because that is who we are.  That is our calling.  That is our character.  Thank you, God Bless You, and may God Bless the United States of America.”

Now the Republican response by Representative Charles Boustany (R-LA):

Republicans are ready for reform.  We’ve lost jobs since February.  “Americans want health care reform … [They're saying] it’s time to start over with a … bipartisan plan.”

He’s saying that Obama’s plan will cost Americans more – that even the Congressional Budget Office agrees – it’ll create 53 new bureaus and raise the deficit.  It won’t make the program better for seniors.

“The President [could have] taken government run health care off the table, but he didn’t.”

Americans should be able to get insurance with preexisting conditions.  We should give incentives for healthy choices and preventative care.

“We’re grateful that the President mentioned medical liability reform.”  “Junk lawsuits drive up the cost of medical care.”

We should establish a plan that would enable people to buy insurance across state lines – and that was one of McCain’s big pushes during the ’08 campaign that I really agreed with.

“This Congress can pass meaningful reform soon … working together in a bipartisan way, we can lower the cost of health care.”

Alright – I wasn’t able to catch that much of the response because there weren’t any pauses in that speech, but it was basically the same thing that McCain said during his Presidential campaign.

Overall, I think the President did a moderately good job.  I wish he would’ve gone into detail a little more than he did, and there are some things that I definitely disagree with, but there were some good points:

Malpractice/tort reform is a huge part of the plan that will help lower costs of health care.  Eliminating waste in Medicaid and Medicare is another great thing that we need to do.  Ensuring a way that people can keep their coverage even when they get sick is another necessity that almost everybody agrees with.

I disagree with the public option, and I disagree with forcing people to have some sort of insurance plan.

I wish that he would consider adopting the plan to allow people to cross state borders to purchase health care plans.

Overall, it was a good speech, but I think he took a couple too many jabs at Republicans and the Bush administration (he’s going to need some Republicans’ votes, and that wasn’t a way to win them over).  I also wish he would’ve had more details of his plan, but with only having 45 minutes, that’s hard to do.

I’m not sold on the President’s plan, but I do think there are some good parts of the plan that I’d like to see develop.

We’ll see what’s introduced and what Congress does with the bill(s).

Done Analyzing,

Ranting Republican

Analysis of Senator Ted Kennedy’s Speech at the DNC

August 25, 2008

I gotta say, I hate his politics, but that was a great video tribute (available here and the second part here).

I wasn’t expecting him to come in person, I had heard he wouldn’t be able to make it due to his health.

Good speech so far – very charismatic (like his brother).

And wow – the floor erupted when he promised to be there in January.

Overall, it was a good speech, I mean, I don’t stand for hardly anything he was talking about (healthcare, Obama, etc…), but he’s such a powerful and inspirational speaker.  He reminds me a little bit of Tony Snow, but he’s as loved as much as Newt Gingrich was.

Unfortunately, I didn’t get over to my laptop in time to actually blog about what he was saying, but it was a very inspirational speech (and honestly, like most convention speeches, there’s not much to write about, because most of them are more of a speech to get the crowd excited than an acutal substance speech, and this goes for the Republicans too).

Here’s a link to the video.  I’ll try to do a live blog as Michelle Obama speaks.

Done Reporting,

Ranting Republican
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John McCain Releases New Ad and Gives Speech: Health Care Action

April 29, 2008

Alright, so John McCain released a new ad today, giving a rough outline of his health care plan:

I thought the ad was good overall.  It briefly addressed each of his main points.  The music fit well.  He could’ve elaborated more on allowing people to cross state lines to get health care.  I guess the biggest problem I had with it, is the fact that he is clearly sick while filming the add, which makes it somewhat ironic.  Overall, I give this add a grade of B.

McCain also gave a speech today, at the University of South Florida, Lee Moffitt Cancer Center and Research Institute, in Tampa:

Remarks By John McCain On Health Care On Day Two Of The “Call To Action Tour”

April 29, 2008

ARLINGTON, VA — U.S. Senator John McCain will deliver the following remarks as prepared for delivery at the University of South Florida – Lee Moffitt Cancer Center & Research Institute, in Tampa, FL, today at 10:00 a.m. EDT:

Thank you. I appreciate the hospitality of the University of South Florida, and this opportunity to meet with you at the Moffitt Cancer Center and Research Institute. Speaker Moffitt, Dr. Dalton, Dean Klasko, thank you for the invitation, and for your years of dedication that have made this campus a center of hope for cancer victims everywhere. It’s good to see some other friends here, including your board member and my friend and former colleague Connie Mack. And my thanks especially to the physicians, administrators, and staff of this wonderful place.

Sometimes in our political debates, America’s health-care system is criticized as if it were just one more thing to argue about. Those of you involved in running a research center like this, or managing the children’s hospital that I visited yesterday in Miami, might grow a little discouraged at times listening to campaigns debate health care. But I know you never lose sight of the fact that you are each involved in one of the great vocations, doing some of the greatest work there is to be done in this world. Some of the patients you meet here are in the worst hours of their lives, filled with fear and heartache. And the confident presence of a doctor, the kind and skillful attentions of a nurse, or the knowledge that researchers like you are on the case, can be all they have to hold onto. That is a gift only you can give, and you deserve our country’s gratitude.

I’ve had a tour here this morning, and though I can’t say I absorbed every detail of the research I certainly understand that you are making dramatic progress in the fight against cancer. With skill, ingenuity, and perseverance, you are turning new technologies against one of the oldest enemies of humanity. In the lives of cancer patients, you are adding decades where once there were only years, and years where once there were only months. You are closing in on the enemy, in all its forms, and one day you and others like you are going to save uncounted lives with a cure for cancer. In all of this, you are showing the medical profession at its most heroic.

In any serious discussion of health care in our nation, this should always be our starting point – because the goal, after all, is to make the best care available to everyone. We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need, and the peace of mind that comes with knowing they are covered. Health care in America should be affordable by all, not just the wealthy. It should be available to all, and not limited by where you work or how much you make. It should be fair to all; providing help where the need is greatest, and protecting Americans from corporate abuses. And for all the strengths of our health-care system, we know that right now it falls short of this ideal.

And this right here proves Dean’s erroneous accusations that McCain doesn’t want children to have health care wrong.  Obviously, McCain wants everybody to have health care, he just doesn’t think the government should be running the health care system.

Some 47 million individuals, nearly a quarter of them children, have no health insurance at all. Roughly half of these families will receive coverage again with a mother or father’s next job, but that doesn’t help the other half who will remain uninsured. And it only draws attention to the basic problem that at any given moment there are tens of millions of Americans who lost their health insurance because they lost or left a job.

Another group is known to statisticians as the chronically uninsured. A better description would be that they have been locked out of our health insurance system. Some were simply denied coverage, regardless of need. Some were never offered coverage by their employer, or couldn’t afford it. Some make too little on the job to pay for coverage, but too much to qualify for Medicaid or other public programs. There are many different reasons for their situation. But what they all have in common is that if they become ill, or if their condition gets worse, they will be on their own – something that no one wants to see in this country.

Underlying the many things that trouble our health care system are the fundamental problems of cost and access. Rising costs hurt those who have insurance by making it more expensive to keep. They hurt those who don’t have insurance by making it even harder to obtain. Rising health care costs hurt employers and the self-employed alike. And in the end they threaten serious and lasting harm to the entire American economy.

These rising costs are by no means always accompanied by better quality in care or coverage. In many respects the system has remained less reliable, less efficient, more disorganized and prone to error even as it becomes more expensive. It has also become less transparent, in ways we would find unacceptable in any other industry. Most physicians groups and medical providers don’t publish their prices, leaving Americans to guess about the cost of care, or else to find out later when they try to make sense of an endless series of “Explanation of Benefits” forms.

There are those who are convinced that the solution is to move closer to a nationalized health care system. They urge universal coverage, with all the tax increases, new mandates, and government regulation that come along with that idea. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We’ll have all the problems, and more, of private health care — rigid rules, long waits and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

I mean, look at the post office.  Compare the time it takes to wait in line at the post office, to the time it takes at a UPS station.  Or what about the Secretary of State?  If the emergency room waiting time was as long as in the SOS offices, nobody would live (not that a lot of ER waiting times are decent right now either).

The key to real reform is to restore control over our health-care system to the patients themselves. Right now, even those with access to health care often have no assurance that it is appropriate care. Too much of the system is built on getting paid just for providing services, regardless of whether those services are necessary or produce quality care and outcomes. American families should only pay for getting the right care: care that is intended to improve and safeguard their health.

Great point!

When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most expensive and often unnecessary options, and are more satisfied with their choices. We took an important step in this direction with the creation of Health Savings Accounts, tax-preferred accounts that are used to pay insurance premiums and other health costs. These accounts put the family in charge of what they pay for. And, as president, I would seek to encourage and expand the benefits of these accounts to more American families.

Americans need new choices beyond those offered in employment-based coverage. Americans want a system built so that wherever you go and wherever you work, your health plan is goes with you. And there is a very straightforward way to achieve this.

Under current law, the federal government gives a tax benefit when employers provide health-insurance coverage to American workers and their families. This benefit doesn’t cover the total cost of the health plan, and in reality each worker and family absorbs the rest of the cost in lower wages and diminished benefits. But it provides essential support for insurance coverage. Many workers are perfectly content with this arrangement, and under my reform plan they would be able to keep that coverage. Their employer-provided health plans would be largely untouched and unchanged.

Good.  I like the fact that he’s giving those people who are happy with how they are a chance to keep their insurance the same way as it is now, unlike the Democrats.

But for every American who wanted it, another option would be available: Every year, they would receive a tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. It would be yours and your family’s health-care plan, and yours to keep.

And this makes it so that the money is actually put toward health care, just like it is when the companies are given the tax break.  This differs from our current welfare plans where I see people using their food stamps to buy THREE Snickers bars.

The value of that credit – 2,500 dollars for individuals, 5,000 dollars for families – would also be enhanced by the greater competition this reform would help create among insurance companies. Millions of Americans would be making their own health-care choices again. Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs. It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost.

It would help extend the advantages of staying with doctors and providers of your choice. When Americans speak of “our doctor,” it will mean something again, because they won’t have to change from one doctor or one network to the next every time they change employers. They’ll have a medical “home” again, dealing with doctors who know and care about them.

And doctors won’t be overwhelmed like they would be under a universal system.  And bad doctors will be held accountable, in that they won’t get paid no matter what.  People will still have to choose their doctors.

These reforms will take time, and critics argue that when my proposed tax credit becomes available it would encourage people to purchase health insurance on the current individual market, while significant weaknesses in the market remain. They worry that Americans with pre-existing conditions could still be denied insurance. Congress took the important step of providing some protection against the exclusion of pre-existing conditions in the Health Insurance Portability and Accountability Act in 1996. I supported that legislation, and nothing in my reforms will change the fact that if you remain employed and insured you will build protection against the cost of treating any pre-existing condition.

Even so, those without prior group coverage and those with pre-existing conditions do have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need. I will work tirelessly to address the problem. But I won’t create another entitlement program that Washington will let get out of control. Nor will I saddle states with another unfunded mandate. The states have been very active in experimenting with ways to cover the “uninsurables.” The State of North Carolina, for example, has an agreement with Blue Cross to act as insurer of “last resort.” Over thirty states have some form of “high-risk” pool, and over twenty states have plans that limit premiums charged to people suffering an illness and who have been denied insurance.

Good – it doesn’t create a system that the government can’t afford, which would mean just more and more taxes.  Let the states decide how to do things, putting the Constitution and Federalism to use, like they were designed to be.

As President, I will meet with the governors to solicit their ideas about a best practice model that states can follow – a Guaranteed Access Plan or GAP that would reflect the best experience of the states. I will work with Congress, the governors, and industry to make sure that it is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs. These programs reach out to people who are at risk for different diseases and chronic conditions and provide them with nurse care managers to make sure they receive the proper care and avoid unnecessary treatments and emergency room visits. The details of a Guaranteed Access Plan will be worked out with the collaboration and consent of the states. But, conceptually, federal assistance could be provided to a nonprofit GAP that operated under the direction of a board that i ncluded [sic] all stakeholders groups – legislators, insurers, business and medical community representatives, and, most importantly, patients. The board would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.

Again, giving states the choice is the best thing to do here.  And the whole interstate insurrance option is a GREAT idea.  More competition means better prices for the consumers.

This cooperation among states in the purchase of insurance would also be a crucial step in ridding the market of both needless and costly regulations, and the dominance in the market of only a few insurance companies. Right now, there is a different health insurance market for every state. Each one has its own rules and restrictions, and often guarantees inadequate competition among insurance companies. Often these circumstances prevent the best companies, with the best plans and lowest prices, from making their product available to any American who wants it. We need to break down these barriers to competition, innovation and excellence, with the goal of establishing a national market to make the best practices and lowest prices available to every person in every state.

Again – the interstate part of his plan is a GREAT idea.

Another source of needless cost and trouble in the health care system comes from the trial bar. Every patient in America must have access to legal remedies in cases of bad medical practice. But this vital principle of law and medicine is not an invitation to endless, frivolous lawsuits from trial lawyers who exploit both patients and physicians alike. We must pass medical liability reform, and those reforms should eliminate lawsuits directed at doctors who follow clinical guidelines and adhere to patient safety protocols. If Senator Obama and Senator Clinton are sincere in their conviction that health care coverage and quality is their first priority, then they will put the needs of patients before the demands of trial lawyers. They can’t have it both ways.

AMEN!!!!  I hate frivolous lawsuits (just read my blog “disclaimer”).  Too many lawsuits occur that never should be allowed to, and even the ones that should win the case, are often awarded in too great amounts.  And neither Clinton or Obama are going to say that if they ever want the chance of getting John Edwards’s delegates.

We also know from experience that coordinated care – providers collaborating to produce the best health outcome – offers better quality and can cost less. We should pay a single bill for high-quality disease care, not an endless series of bills for pre-surgical tests and visits, hospitalization and surgery, and follow-up tests, drugs and office visits. Paying for coordinated care means that every single provider is now united on being responsive to the needs of a single person: the patient. Health information technology will flourish because the market will demand it.

Again – this is a great idea.  I remember several times when my family members had to be hospitalized for various issues, and it was just charge after charge, for X test or Y medicine and then an MRI or CAT scan, and the bills just piled up.

In the same way, clinics, hospitals, doctors, medical technology producers, drug companies and every other provider of health care must be accountable to their patients and their transactions transparent. Americans should have access to information about the performance and safety records of doctors and other health care providers and the quality measures they use. Families, insurance companies, the government – whoever is paying the bill – must understand exactly what their care costs and the outcome they received.

Exactly.  One of the things that he doesn’t address specifically, but falls under this category of transparency is ambulances.  Nowadays, ambulance rides aren’t necessarily covered under insurrance plans, but they can be QUITE expensive.  And I’ve seen cases where ambulances are called unnecessarily because people simply don’t need an ambulance (such as the case of my girlfriend, who has seizures.  She’s had them in public, and people, not knowing that she doesn’t need an ambulance, call 911, and she gets hit with a huge bill).

Families also place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in Web technology to allow a doctor to practice across state lines, then let them.

Again, this emphasizes McCain’s (and Republican’s/Libertarian’s) points at large, that people/consumers should have the freedom to choose WHATEVER they want, whether that’s what we consider “conventional” or not.

As you know better than I do, the best treatment is early treatment. The best care is preventative care. And by far the best prescription for good health is to steer clear of high-risk behaviors. The most obvious case of all is smoking cigarettes, which still accounts for so much avoidable disease. People make their own choices in this country, but we in government have responsibilities and choices of our own. Most smokers would love to quit but find it hard to do so. We can improve lives and reduce chronic disease through smoking cessation programs. I will work with business and insurance companies to promote the availability and use of these programs.

OK – I need to know more about what this program would do.  I don’t like smoking, but its a choice that people have the right to make, and when the government bans smoking in private areas (in my opinion, it should be banned in public areas if that’s what people want – it’s the people’s air, it should be their choice), they begin going down a slippery slope.  I’m not saying this is what McCain wants to do, I’m just saying that I need to know more details about this specific plan before I am comfortable commenting on it.

Smoking is just one cause of chronic diseases that could be avoided or better managed, and the national resources that could be saved by a greater emphasis on preventative care. Chronic conditions – such as cancer, heart disease, high blood pressure, diabetes and asthma – account for three-quarters of the nation’s annual health-care bill. In so many cases this suffering could be averted by early testing and screening, as in the case of colon and breast cancers. Diabetes and heart disease rates are also increasing today with rise of obesity in the United States, even among children and teenagers. We need to create a “next generation” of chronic disease prevention, early intervention, new treatment models and public health infrastructure. We need to use technology to share information on “best practices” in health care so every physician is up-to-date. We need to adopt new treatment programs and fi nancial [sic] incentives to adopt “health habits” for those with the most common conditions such as diabetes and obesity that will improve their quality of life and reduce the costs of their treatment.

Financial incentives for “health habits”?  This seems to cross the line to me.  If somebody wants to be obese, that’s their own choice.  I don’t see why the government should offer a monetary incentive to be healthy.  Shouldn’t the fact that you’ll live longer (in theory) be enough incentive?  If a private company wants to form to give out these incentives, then go ahead, but this is too much governemnt involvement for my liking.

Watch your diet, walk thirty or so minutes a day, and take a few other simple precautions, and you won’t have to worry about these afflictions. But many of us never quite get around to it, and the wake-up call doesn’t come until the ambulance arrives or we’re facing a tough diagnosis.

We can make tremendous improvements in the cost of treating chronic disease by using modern information technology to collect information on the practice patterns, costs and effectiveness of physicians. By simply documenting and disseminating information on best practices we can eliminate those costly practices that don’t yield corresponding value. By reforming payment systems to focus on payments for best practice and quality outcomes, we will accelerate this important change.

Government programs such as Medicare and Medicaid should lead the way in health care reforms that improve quality and lower costs. Medicare reimbursement now rewards institutions and clinicians who provide more and more complex services. We need to change the way providers are paid to focus their attention more on chronic disease and managing their treatment. This is the most important care for an aging population.

There have been a variety of state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that are different from the inflexible approaches for delivering care to people in the home setting. Seniors are given a monthly allowance that they can use to hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. It also offers counseling and bookkeeping services to assist consumers in handling their programmatic responsibilities.

In these approaches, participants were much more likely to have their needs met and be satisfied with their care. Moreover, any concerns about consumers’ safety appear misplaced. For every age group in every state, participants were no more likely to suffer care-related health problems.

Again, this just goes to show that leaving it up to the states is a good idea.

Government can provide leadership to solve problems, of course. So often it comes down to personal responsibility – the duty of every adult in America to look after themselves and to safeguard the gift of life. But wise government policy can make preventative care the standard. It can put the best practices of preventative care in action all across our health-care system. Over time that one standard alone, consistently applied in every doctor’s office, hospital, and insurance company in America, will save more lives than we could ever count. And every year, it will save many billions of dollars in the health-care economy, making medical care better and medical coverage more affordable for every citizen in this country.

Preventative stuff IS cheaper in the long run.  Sure, it costs more at the beginning, but it’s (usually) cheaper in the long run.

Good health is incentive enough to live well and avoid risks, as we’re all reminded now and then when good health is lost. But if anyone ever requires further motivation, they need only visit a place like the Moffitt Center, where all the brilliance and resourcefulness of humanity are focused on the task of saving lives and relieving suffering. You’re an inspiration, and not only to your patients. You’re a reminder of all that’s good in American health care, and we need that reminder sometimes in Washington. I thank you for your kind attention this morning, I thank you for the heroic work you have done here, and I wish you success in the even greater work that lies ahead.

And that wraps up McCain’s speech.

Lastly, I want to give you the information from McCain’s website’s page about health care, which essentially outlines the plan that he laid out in the above speech:

Straight Talk on Health System Reform
A Call to Action
Today, In Florida, John McCain Outlined His Plan For Health Care Reform.
John McCain believes we can and must provide access to health care for every American. He has proposed a comprehensive vision for achieving that. For too long, our nation’s leaders have talked about reforming health care. Now is the time to act.

  • Americans Are Worried About Health Care Costs.The problems with health care are well known: it is too expensive and 47 million people living in the United States lack health insurance.

John McCain's Vision for Health Care Reform
John McCain Believes The Key To Health Care Reform Is To Restore Control To The Patients Themselves.
We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need. Health care should be available to all and not limited by where you work or how much you make. Families should be in charge of their health care dollars and have more control over care.

Making Health Insurance Innovative, Portable and Affordable
John McCain Will Reform Health Care Making It Easier For Individuals And Families To Obtain Insurance.
An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people’s needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.
McCain EventJohn McCain Will Reform The Tax Code To Offer More Choices Beyond Employer-Based Health Insurance Coverage. While still having the option of employer-based coverage, every family will also have the option of receiving a direct refundable tax crediteffectively cash – of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider. Those obtaining innovative insurance that costs less than the credit can deposit the remainder in expanded Health Savings Accounts.
 
John McCain Proposes Making Insurance More Portable. Americans need insurance that follows them from job to job. They want insurance that is still there if they retire early and does not change if they take a few years off to raise the kids.
 
 

 

 

John McCain Will Encourage And Expand The Benefits Of Health Savings Accounts (HSAs) For Families. When families are informed about medical choices, they are more capable of making their own decisions and often decide against unnecessary options. Health Savings Accounts take an important step in the direction of putting families in charge of what they pay for.
Ensuring Care for Higher Risk Patients
John McCain’s Plan Cares For The Traditionally Uninsurable.
John McCain understands that those without prior group coverage and those with pre-existing conditions have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need.
John McCain Will Work With States To Establish A Guaranteed Access Plan. As President, John McCain will work with governors to develop a best practice model that states can follow - a Guaranteed Access Plan or GAP – that would reflect the best experience of the states to ensure these patients have access to health coverage. One approach would establish a nonprofit corporation that would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.
 
John McCain Will Promote Proper Incentives. John McCain will work with Congress, the governors, and industry to make sure this approach is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs.
 

 

 

 

Lowering Health Care Costs
John McCain Proposes A Number Of Initiatives That Can Lower Health Care Costs. If we act today, we can lower health care costs for families through common-sense initiatives. Within a decade, health spending will comprise twenty percent of our economy. This is taking an increasing toll on America’s families and small businesses. Even Senators Clinton and Obama recognize the pressure skyrocketing health costs place on small business when they exempt small businesses from their employer mandate plans.
 
 
 
 
 

 

  • CHEAPER DRUGS: Lowering Drug Prices. John McCain will look to bring greater competition to our drug markets through safe re-importation of drugs and faster introduction of generic drugs.
  • CHRONIC DISEASE: Providing Quality, Cheaper Care For Chronic Disease. Chronic conditions account for three-quarters of the nation’s annual health care bill. By emphasizing prevention, early intervention, healthy habits, new treatment models, new public health infrastructure and the use of information technology, we can reduce health care costs. We should dedicate more federal research to caring and curing chronic disease.
  • COORDINATED CARE: Promoting Coordinated Care. Coordinated care – with providers collaborating to produce the best health care – offers better outcomes at lower cost. We should pay a single bill for high-quality disease care which will make every single provider accountable and responsive to the patients’ needs. McCain Event
  • GREATER ACCESS AND CONVENIENCE: Expanding Access To Health Care. Families place a high value on quickly getting simple care. Government should promote greater access through walk-in clinics in retail outlets.
  • INFORMATION TECHNOLOGY: Greater Use Of Information Technology To Reduce Costs. We should promote the rapid deployment of 21st century information systems and technology that allows doctors to practice across state lines.
  • MEDICAID AND MEDICARE: Reforming The Payment System To Cut Costs. We must reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination. Medicaid and Medicare should not pay for preventable medical errors or mismanagement.
  • SMOKING: Promoting The Availability Of Smoking Cessation Programs. Most smokers would love to quit but find it hard to do so. Working with business and insurance companies to promote availability, we can improve lives and reduce chronic disease through smoking cessation programs.
  • STATE FLEXIBILITY: Encouraging States To Lower Costs. States should have the flexibility to experiment with alternative forms of access, coordinated payments per episode covered under Medicaid, use of private insurance in Medicaid, alternative insurance policies and different licensing schemes for providers.
  • TORT REFORM: Passing Medical Liability Reform. We must pass medical liability reform that eliminates lawsuits directed at doctors who follow clinical guidelines and adhere to safety protocols. Every patient should have access to legal remedies in cases of bad medical practice but that should not be an invitation to endless, frivolous lawsuits.
  • TRANSPARENCY: Bringing Transparency To Health Care Costs. We must make public more information on treatment options and doctor records, and require transparency regarding medical outcomes, quality of care, costs and prices. We must also facilitate the development of national standards for measuring and recording treatments and outcomes.

Confronting the Long Term Care Challenge
John McCain Will Develop A Strategy For Meeting The Challenge Of A Population Needing Greater Long-Term Care. There have been a variety of state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that are pioneering approaches for delivering care to people in a home setting. Seniors are given a monthly stipend which they can use to: hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. It also offers counseling and bookkeeping services to assist consumers in handling their programmatic responsibilities.

Covering Those With Pre-Existing Conditions
MYTH: Some Claim That Under John McCain’s Plan, Those With Pre-Existing Conditions Would Be Denied Insurance.
 
 
 
 
 

 

  • FACT: John McCain Supported The Health Insurance Portability And Accountability Act In 1996 That Took The Important Step Of Providing Some Protection Against Exclusion Of Pre-Existing Conditions.
  • FACT: Nothing In John McCain’s Plan Changes The Fact That If You Are Employed And Insured You Will Build Protection Against The Cost Of Any Pre-Existing Condition.
  • FACT: As President, John McCain Would Work With Governors To Find The Solutions Necessary To Ensure Those With Pre-Existing Conditions Are Able To Easily Access Care.
 

And there you have McCain’s health care plan.  I don’t like all of it, but I really do like that fact that he’s coming at this from an innovative way, not just paying for it like the Democrats want to do, but allowing for more competition between health care providers.  I think his plan is much better than any plan that the Democrats have outlined.

Done Analyzing,

Ranting Republican
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Still No Smoking Ban In Michigan

December 16, 2007

A smoking ban bill that cleared the Michigan House earlier this week seems to have stalled in the Senate.  The bill would ban smoking in restaurants, bars, and other workplaces.

The Democrats tried to send the bill to the Health Policy Committee, where the Republican chair, Dr. Tom George (R-Kalamazoo) supports the ban; instead, the bill was sent to the Government Operations and Reform Committee, chaired by Senate Majority Leader Mike Bishop (R-Rochester).  Dr. Roger Kahn (R-Saginaw) who also supports the ban, voted to send it to Bishop’s committee in order to respect the Majority Leader’s wishes of sending the bill where he wanted to.

If all 17 Democratic Senators, plus George and Kahn vote for the bill, Lt. Governor Don Cherry could cast the tie-breaking vote for it, and Governor Granholm would be expected to sign it into law.

Here are my thoughts: Do I support THIS ban?  No.  Would I support an initiative brought up by the people?  Yes.  I just don’t see a smoking ban as something the government needs to get into.  If you don’t like smoke, don’t go to a restaurant where there’s smoke.  People argue that with the second hand smoke, “It’s unhealthy for my kids in those restaurants.”  Yeah, well, the food that they’re eating there probably isn’t as healthy as a well-cooked organic meal that you could eat back home either.  On the other side, many people say that it’d be bad for businesses and the economy.  I don’t buy this though (for bars, yes, but for most restaurants, no).  I know quite a few smokers (even most of my extended family) and they can all go out to dinner and not have a cigarette for 2 hours (if you NEED one, then go outside, or get one of those Nico-patch thingies).  As well, last time I checked, McDonald’s and Burger King weren’t going out of business, and you can’t smoke there.

So – I think Michigan should be smoke free, but if it’s so important like people are now complaining that it is, then go out, draft a bill, get the signatures and get it on the November ballot.  THEN I’ll vote for it.

(It should be noted that there are many Senators who don’t think the bill is completely dead yet, but that it would stand a better chance in the Health Policy Committee, so I’ll keep you updated on this story).

Done Ranting,

Ranting Republican
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