Blue Dog: "Fuck the fisc. Make doctors richer."
Mike Ross and his fellow Blue Dogs have been beating the rest of the House and Senate Dems about the head and shoulders everytime any sensible health care reform promises negatively to impact the near term deficit numbers. In particular, they declare the “public option” DOA, even threatening to bolt party discipline if forced to vote in its favor.
Frequently, their aversion to spending public funds is couched in flowery and ideologically ornate protestations about self reliance and liberty and such shit.
It turns out that Ross is ok with the public option closest to single provider, Medicare for everybody , just as long as we spend .more public money.:
“Medicare could be offered as a choice to compete alongside private insurers for those Americans eligible to enter the national health insurance exchange, but at a reimbursement rate much greater than current Medicare rates,”
Medicare is already 75% funded from the general fisc; Blue Dog Ross wants to add a generous surcharge, which will all fall to the puclicly financed portion, meaning higher taxes/deficits, all so that health care costs can be protected from reduction.
It’s nice when the running dogs of the rich and rapacious are stupid enough to show their true colors.
The Blue Dogs are about 80 percent wrong and 20 percent right in their position. To change the unsustainable trajectory of rising healthcare costs will requiring healthcare restructuring that dramatically reduces excessive payments to many hospitals and providers. On the other hand, there are regions of the country where physicians and hospitals doing good work are nevertheless struggling to stay afloat financially. Increasing reimbursements to everyone isn't the answer, but some judiciousness in deciding where to cut is called for.
October 23, 2009 5:23 PM | Reply | Permalink
struggling to stay afloat
True, boat payments are onerous...
Which is to say, "struggling" may mean treating half your patients on a barter for live chickens basis and working 15 hour days to make sure no one is left without care, or, it may mean letting the gardener go part time.
Part of the re-evaluation of health care delivery certainly may bring us to ask how many standard deviations from the median family income it takes to "incentivize" (precious blood of the sweet baby Jesus, that is not a word!) the choice of medecine as a career.
October 23, 2009 5:30 PM | Reply | Permalink
I agree with your sentiment JR, at least for elder doctors. But I would like to add that today medical school costs are simply insane. Two of my best friends are nearly complete and they are graduating with 210k, and 225k respectively. Both want to be general practitioners and therefore will not make anywhere near what specialists make.
I know that eventually they will be able to pay this off, and well then be fairly well off but it really is ridiculous the amount of debt we force our students to incur. We badly need to reform this, and not just by eliminating the middleman like the current proposals do (although that is a great thing).
October 23, 2009 5:40 PM | Reply | Permalink
So when a new doctor gets out into the world he is eager to go wtih whoever pays the most the sonnest, and who might that be?!?!?
October 24, 2009 2:38 AM | Reply | Permalink
the most, the soonest ... but you knew that!
October 24, 2009 2:38 AM | Reply | Permalink
Isn't the federal gov. supposed to do what state and local gov. or the people and private business either cannot or will not do for themselves.
Our country has a shortage of doctors. Our system is not turning out enough of them. As part of the long term plan, how about a public option on higher education? Let the federal government establish a medical school and every time that applications by qualified students goes, say, fifteen percent over capacity another school is opened.
October 24, 2009 11:41 AM | Reply | Permalink
It is perfectly clear the medical community enjoys it's limited-entry arrangement for developing doctors. It is also clear that the organizations hawking medical services enjoy suggesting a PA-C is as good as a doctor. You ask to see a doctor and you have to get by the PA-C first. There are not enough doctors and we should build more schools for them. YES!!!
October 24, 2009 12:00 PM | Reply | Permalink
we force our students to incur
I guess cutting the banks out of their old student loan racket can only help, but my thumbnail number on annual inflation in trade school tuition feels like 10-15%...on almost a permanent basis, which makes me sorry i didn't take that job at University of Illinois--who knew teaching was going to be so high paying?
(OK, so we know the money isnt going there, unless you get your textbook adopted at 2-3 dollars per page, but obviously, the next area of attack is on restrictive trade school practices and generous deals involving debt forgiveness in exchange for some number of years practicing in East Jibib.
Compare France, where the free public higher education turns out sufficient medical professionals to keep the costs of their free health care in bounds. But who wants to be like the french...(who wants beautiful women who spend twice as much of their disposable income on beauty as other women...who wants bread baked a half hour ago...never mind...)
American Exceptionalism, worth every penny it costs--"you gotta pay the cost to be the boss"...
October 23, 2009 5:52 PM | Reply | Permalink
Did somebody say fresh bread? Get those French chicks outta here, the man said FRESH BREAD!!!
Med students? BAH HUMBUG! I'd as soon incent flatulence as that lot.
October 23, 2009 7:49 PM | Reply | Permalink
incent
Syntax and usage be damned! Sharpen your cutlass and tie up your balls, we're going to board her!
Which is to say, I'll probably take the shorter non existent verb over the longer one...
October 24, 2009 2:03 AM | Reply | Permalink
Get your back formations in motion, baby. Incent seems to be following diagnose, escalate and enthuse onto the playing field.
Which means we could carve up "incentivize" and use it for parts.
Anybody need a spare "ivize"?
October 25, 2009 2:14 PM | Reply | Permalink
Having spent a fair amount of time in the north of France I can't for the life of me figure out why so many in this country are on their case. There is a lot they get very right. Are we so much better? My personal comparison doesn't support that assertion.
October 24, 2009 9:29 AM | Reply | Permalink
Jolly, the MSM has now changed its tune and says we are going to get public option. Frankly we need it so that in the years to come it will expand to include more and more people.
CAPITALISM DOES NOT WORK IN THE AREA OF PUBLIC HEALTH. PERIOD.
October 23, 2009 8:08 PM | Reply | Permalink
.in the years to come it will expand
I forget which of the opponents had the ill-advised candor to worry that it was just "the nose of the camel under the tent" (already a very suspect metaphor).
Of course, just as this worthy opined, the idea is for the public option to swallow up all the plans delivering less care for more cost (how's that for the invisible hand of the market?) and turn into single payer.
So this guy is not wrong about the outcome--he's wrong in deploring it.
October 24, 2009 2:07 AM | Reply | Permalink
Personally, I'm partial to the image of a hapless camel sliding down the slippery slope on his way to the thin edge of the wedge.
If you give a camel an inch, will it crack the foundation?
October 24, 2009 11:37 AM | Reply | Permalink
"Medicare could be offered as a choice to compete alongside private insurers for those Americans eligible to enter the national health insurance exchange, but at a reimbursement rate much greater than current Medicare rates"
We need to allow unliscenced doctors to practice. That will give consumers more choices. Also, we need to allow doctors to deny care to anyone that can't pay for it.
October 29, 2009 6:57 PM | Reply | Permalink