Sunday, September 20, 2009

Some Questions About The Health Care Plan

Last Thursday, House Republicans published ten "common sense" questions arising from President Obama's health care reform speech. (Hat tip to ADoc2Be who mentions this on her own blog.) Here are the statements from the speech and the questions thereof:

President Barack Obama: “Our collective failure to meet this challenge – year after year, decade after decade – has led us to the breaking point.”

Common Sense Question: If we are at the “breaking point,” then why doesn’t your government-run insurance plan start until 2013?

Dalai's Comment: Clearly, this is timed to start AFTER the 2012 election. How stupid does Mr. Obama think we are? Wait, don't answer that. Whilst I agree that something needs to be done, I am in utter disbelief that GM and Chrysler were felt to be greater "emergencies" than health care, so horrible that we had to borrow trillions of dollars against our descendants. Health care, a life-or-death proposition if there ever was one, has to be pre-funded and deficit-neutral, which means increasing taxes in some stealthy manner. Add the omission of tort-reform and we realize that this is nothing more than a power-grab, an attempt to place a huge chunk of our economy under governmental control, as well as a poorly-disguised scheme to redistribute wealth.

President Barack Obama: “There are now 30 million American citizens who cannot get coverage.”

Common Sense Question: On August 20, you said 46 million Americans were uninsured. What happened to 16 million Americans?

Dalai's Comment: "Cannot" get coverage or "will not" get coverage? There is a huge difference. The numbers are too nebulous to be the full basis for anything. I agree completely that something has to be done about this, having a child that will be uninsurable because of a chronic illness once he leaves my policy. But we do not have to destroy what we have to achieve that goal.

President Barack Obama: “And every day, 14,000 Americans lose their coverage.”

Common Sense Question: Does that mean 15 million Americans will lose their health care before your government plan starts in 2013?

President Barack Obama: “We spend one and a half times more per person on health care than any other country, but we aren’t any healthier for it.”

Common Sense Question: Then why do people travel from around the world to receive health care in the United States?

Dalai's Comment: As noted by my fellow blogger, ADoc2Be, we are not as healthy as we should be due to a significant number of us (including me) making bad choices. We overeat (that's my vice) we smoke, we drink to excess. And then we want to make that someone else's fault. We the physicians can and do try to limit these behaviours in our patients, but to little avail.

Those with means around the world in vast majority come here for high-level care, not to Britain, France, Japan, Germany, Switzerland, or a host of other nations with "progressive" medical care. Sorry, but that's the fact, Jack.

President Barack Obama: “Put simply, our health care problem is our deficit problem. Nothing else even comes close.”

Common Sense Question: Didn’t the non-partisan Congressional Budget Office say that the health care plan you have endorsed will add $239 billion to our annual deficits over the next ten years?

President Barack Obama: “Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.”

Common Sense Question: If we can pay for “most” of health care reform by controlling waste and inefficiency, then why does a $900 billion health care plan include $820 billion in tax increases?

President Barack Obama: “…no federal dollars will be used to fund abortion.”

Common Sense Question: Do you object to House Democrats defeating an amendment in the House Energy and Commerce Committee markup that would have explicitly prohibited federal funding of abortion under a government-run health care plan?

President Barack Obama: “I will not sign a plan that adds one dime to our deficits – either now or in the future.”

Common Sense Question: Do you oppose the House Democrat health care plan, H.R. 3200, which the non-partisan Congressional Budget Office said will add $239 billion to our annual deficits over the next ten years and “would probably generate substantial increases in federal budget deficits” thereafter? If so, which Democrat plan are you going to support?

Dalai's Comment: See above. The finances don't make any sense at all.

President Barack Obama: “Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan…the plan I’m proposing will cost around $900 billion over the next 10 years…”

Common Sense Question: If there is so much “waste and inefficiency” in Medicare and Medicaid – two government-run health care plans – then won’t further government involvement in health care lead to further “waste and inefficiency”?

Dalai's Comment: And why can't we eliminate the "waste and inefficiency" RIGHT NOW, instead of waiting until 2013? And just HOW are we going to eliminate waste? Uh, maybe we should rephrase that...

President Barack Obama: “And I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen.”

Common Sense Question: Will you agree to meet with House Republican leaders to discuss health care reform, as they requested almost four months ago?

Dalai's Comment: Has Bart sent in his plan yet?

And here are some additional questions, food for thought, mainly. . .

Just what is our goal here? Do we wish to insure everyone? What is the basis for this desire? Are we saying morally that all life is important, and everyone needs to have access to care, and should that care be equal for all? If so, we must insure everyone possible. And I mean EVERYONE. Illegals, citizens of other nations, etc. If the moral imperative exists to provide health care, then we must do so for all. GLOBALLY. Mr. Obama's plan, and the mentality that we must provide (equally is implied) for all of our citizens just as the Socialist nations of the world seem to be doing is apparently based on flawed, jingoistic, nationalistic ideals, yes? It says that we have an obligation to help ONLY our fellow citizens, and how could that be true? A life is a life is a life, right? IF this is our goal, then we cannot allow distinction between a American's life, and an illegal-alien's life. Or the life of someone in Africa? Or India? Or China? And, if all life needs to be preserved, how do we justify allowing (or encouraging) abortion?

I'm just asking philosophical questions. Just something to think about. Here's some more to consider.

We will need quite a few more physicians to accomplish the goal of caring for EVERYONE, even if we incorrectly and unfairly limit this only to every US citizen. How will they train? Those of us who went through medical school know that the patients who present to a training institution (say, a county hospital with a high indigent population) are treated by medical students and residents, albeit under the supervision of an experienced physician. IF everyone deserves equal care, is this FAIR? Would you submit to having a junior medical student suture a laceration on your daughter's face? Why should an indigent have to suffer this humiliation? That's not FAIR, is it?

And another thought. My daughter the pre-med has given me the following analogy, gleaned from her Ethics class: You are walking down a country road, and you see a baby floating face-down in the middle of a nearby pond. Could you just continue to walk by and live with yourself later? Of course not. In this tale, the uninsured are represented by the baby, and we cannot live with ourselves without helping them, and the assumption is made that we aren't helping them. The analogy is heart-rending, but not completely accurate. First, we DO help. My group writes off literally millions of dollars in care for "self-pay" patients. We all know that "self-pay" means "no-pay" but we care for them anyway. Between that and the 50% I presently pay in taxes, I'm doing a HELL OF A LOT more for the poor than just about anyone who wants to criticize me. How much more should I do? Secondly, we can assume that the baby didn't want to end up face down in the pond. But many of our most ill citizens got that way via the vices I outlined above. They may not have explicitly chosen to acquire lung cancer when they lit up a cigarette, but they knew the consequences and rolled the dice. Do we have the obligation to pay for their care? Does an alcoholic dying of cirrhosis deserve a liver-transplant at our expense? Is it FAIR, is it RIGHT?

Back to an earlier point. If this is such an emergency, if insuring EVERYONE is the FAIR and RIGHT thing to do, then we should do so with all possible haste, and damn the cost. We should print money to cover this overwhelming necessity, well, no, let's just declare the health care is FREE, that anything and everything everyone needs is to be delivered gratis. Doctors and other health care workers, and especially pharmaceutical companies won't be paid, because filthy profit should have no say in health care, should it? No, let's do this right, folks.

While we're at it, it isn't FAIR that there are people in this country, and in the rest of the world, for that matter, who don't have enough to eat. Starting now, all food needs to be given away free as well, since people may die or become ill without adequate nutrition. OK, let's start slow. We'll have socialized nationalized food-care, and ultimately take this global. Healthy meals for all! Oh, by the way, we get to tell you what you can eat and what you can't. It isn't FAIR for Dr. Dalai to eat steak (production of which has a huge carbon footprint, and is a very inefficient way to consume food resources), while an impoverished child in North Korea has to eat pine needles.

I could go on, but I won't. Some of my readers have probably blown Circle-of-Willis aneurysms by now, and they will be overtaxing their local health-care delivery systems.

As I did before the last election, I am simply asking you to think about the implications of what you are demanding. I will very stubbornly continue to think that the current "emergency" push for health care revision is nothing more than a sham that has conned a lot of kind-hearted folks (mainly liberals) into BELIEVING. I do realize that our health-care system needs reform, and I doubt that anyone would seriously argue otherwise. But think long and hard about the change you wish to bring about, and why you want it. Think.


A Doc 2 Be said...

Thanks for the tip 'o the hat to my blog!

Free food?! Yeay! No more Ramen, or Franco-American :)

Your daughter makes a good point - no one wants to see anyone go without health care. The "emergency room" plan used more often than not by those uninsured is not the way to go - not for the patient, not for the treating physician as there is no follow-up, and certainly not for the hospital which will incur the goodwill/charity care costs.

Anonymous said...

don't mean to sound rhetorical or leading in this question, just want to know...isn't it far cheaper to treat people early (or maybe even prevent the sickness) than it is to wait for them to show up in ERs? i haven't heard what effect the provision of having to purchase insurance will have on "illegals" showing up in ERs - do they still get free care?
how do we deal with the baby whose caregivers smoke brings them ailments? i'm probably more liberal than you but "kind-hearted" can also mean Christian/God-fearing without meaning socialist
i like the blog! keep up the thought provoking material