Obama's Health Care Reform Won't Fly: But This Will

It's time to pull the plug. Call off the resuscitation team. Bring in the coroner. Health care reform is dead.

Obama gave it a good shot, but it was doomed from the start. It's better that we face it now and start fresh than to perform what would be the equivalent of taxidermy (with emphasis on the tax) and pretend it still exists.

All the talking heads will compare this to Hillary's debacle but in reality the two are nothing alike. In the case of the Clinton's, the failure was one of presentation. There isn't a person alive who can tell you what that plan entailed. If people don't understand something, they aren't going to support it. The message must be clear and if Barack Obama knows anything, he sure knows how to convey a message. Just as Ronald Reagan spoke in a simple folksy manner that clearly described his plans of action, Obama is the modern counterpart -- a hip, confident, straight up speaker who connects with the masses. Yet, he's talking less and less about health care in detail. And with good reason. He knows it's doomed.

We can get into the particulars, but I'll leave that for the TV entertainers -- you know, the loudmouths on both sides, be it Sean Hannity or Keith Olberman, who will blame the opposition as to why the failure occurred, but it's all regurgitated rhetoric. The answers are actually quite simple.

It's pretty obvious that Obama's plate is pretty full right now. I don't think anyone wants the economy, or the war, or the mending of foreign relationships or the potential threat of North Korea to take a back seat to engaging in more bickering over a health plan. And bickering there will be! No matter what plan is presented, the Republicans will try and knock it down. It doesn't matter how good it is, how much it can help the public or how cost effective, it will not get Republican support. They lost their ball and they just don't want to play. The end.

There will also be many Democrats who will vote against it because they don't want to be responsible for the outcome. And I can't blame them. The way it's going, the reform is nothing but a watered down version of the H.I.P. program we had in New York. And anyone who's dealt with them will tell you; it wasn't the greatest. It attracted doctors who hadn't yet established a practice. It was overcrowded and appointment schedules were limited. The waits were endless. You get what you pay for.

What someone must have to guts to say is the dreaded "S" word. Real reform can only come from a socialized medical system, otherwise it's just another version of what already isn't working.

But here's the irony - the one thing nobody mentions. We already have it.

No, I'm not talking about Medicare or Medicaid. In this country there are clinics in every State, every area of the city, every town that provide health care on a sliding scale. All you have to do is walk in and apply. Also, in case of an emergency, there are EMERGENCY rooms in every hospital and they CAN NOT deny you care.

So in reality, we do have a form of socialized medicine and it works pretty well. Is it perfect? No. But nothing can be or will be. When costs are low, service will suffer. That will be the case under any condition and it is the case in any country where health care is provided. You see, this is where the Republicans sneak in that "we have the best care in the world" catch phrase. Sure, if you can afford it. Everyone else will have to settle. But that would be the case no matter what we concoct and it's time we dealt with it.

Raising taxes to simply slightly lower the cost of outrageously overpriced private health care insurance is weak and uninspired. Attempting to revise the entire system is akin to reinventing the wheel -- too much work and the outcome is likely to be sub-par. Instead, we should improve on what we have - walk in coverage for everyone based on income. Provide for more discount chain pharmacy's that have reduced cost prescriptions plans. Allow for refills of scripts without excessive doctor's visits. Right there, I just saved a couple of billion dollars. Now throw that back into the system and make it better. There, is your answer.

People also have to take responsibility for their own health. The saying "an ounce of prevention is worth a pound of cure" has never had a more literal translation. So don't ask the government to stop McDonald's from serving big portions or for Ben and Jerry to keep the chocolate chips out of the chocolate fudge brownie ice cream. And don't try and sue Phillip Morris because you were too stupid to realize that inhaling smoke into your lungs every day wasn't a good idea. It's time we grew up as a people and a nation and took some responsibility.

Will all the optimism I have for the Obama presidency, I'd hate to see this albatross become his Waterloo. Let it go, Barack. And improve on what we have. (Feel free to ask Mike Bloomberg for some advice while you're at it. He knows a thing or two about managing a business.)

Just one more thing. You're going to have to let everyone know - the public and the pundits, the cantankerous conservatives and the lily-livered liberals alike. This is a Socialist program. Call it what it is.

This doesn't mean we're headed for a Marxist regime. It just means we'll be doing what works. And it's about time. I've had this nagging pain in my side and I need to get it checked out.

Comments

[hsr0601]

If you, as opponents to the much-needed, long overdue health care reform, get lost in the deep, steep mountains, or if you are drowning in the water by all your fault, the rescue team run by government will lift you out of such critical status at the huge cost of tax-payer's money as a human life and health can never be exchanged with anything on earth.
And it may be a major roll of government to protect people from any dangers and that's why every modernized state has public 'shared responsibility' policy in place, I guess.
Those who have a different view over this reform, Please keep what you like and respect the others' choice and diversity that the U.S. is proud of on the basis of democracy.

[Roguer]

As an uninsured American, I have a couple questions.­..

What ever happened to the Hippocratic Oath?

Why is the local walkin clinic twice as expensive to visit than my regular doctor?

When did medicine become a for profit corporate enterprise?

Why, when my doctor found out I was uninsured, that suddenly a generic prescription was good enough?

Why, when I messed up my elbow and needed an MRI, was my uninsured price half that of someone that was insured, $500 as opposed to $1000?

What happened to the country doctor that accepted what one could pay, as opposed the post modern physician, turning one away because one could not pay enough?

Could it be because health insurance granted the maximum payment for services as opposed to a competitive rate?

[TheKurgan9]

I'll explain:

#1 - Medicine is a business. Why? Because:

#2 - If you want to become a doctor be prepared to have about $300,000 in student loans. That's what happened to to Hippocratic Oath. The doctor needs to pay back his loans...ju­st like everyone else does.

#3 - Malpractice insurance. Do you know how much money malpractice insurance costs? THOUSANDS of dollars/month.

#4 - Overhead - doctors need to pay rent on their building, pay the office staff, pay for supplies for their office (band-aids, gauze, equipment etc etc) That costs big money just to break even....th­en the Dr. needs to get paid himself/herself a salary. Yes, Dr went to school for 8 years and residency for 2-4 years....t­hey deserve to get paid well.

So that's why medicine costs a fortune.

[Roguer]

So.. let me see if I understand­....

You are saying that Doctors have thrown away their Oath to humanity for money? Money for luxury homes, yachts, BMW's, Hummers, golf on Wednesdays, vacation homes, etc.

You are saying they have overhead and loans? So does every other business and profession. Agriculture has seen input costs more than double but the prices farmers receive have dropped 40%. Buy your logic, a pound of hamburger should cost $25 and corn should be $20 dollars a bushel. Which is more important, yearly doctor's visit or eating?

You are saying they have to pay off student loans? I went to college, worked my way through. Many other professions require years of training, including nurses. Since when did personal loans become a business expense?

Malpractice insurance? Every business carries liability insurance. But not every business owner lives in the luxury that doctors do.

No interest in answering the rest of my questions?

Sorry about my lack of sympathy for the horribly oppressed lives of doctors.

[MzLory]

The ongoing debate over healthcare reform is long-standing and the ideas are absolutely endless. There is no longer any room for being reasonable because the bottom line is how much money can the pharmaceutical companies, health-insurance companies, and the lobbyists who fight for their interests in D.C. The world has completely changed and there is nothing that can make it all go back. The idea of change scares too many ppl into thinking that a lame horse can be made to walk again.

What else can possibly be used in order to make a minimum wage worker walk into a doctor's office without the slightest fear that they will be charged for every single instrument, service, personnel, and time? What has happened is that doctors are becoming arrogant that their time is far more precious than a patient's. The pharmaceutical companies send in their salesppl and bump back the appts log at least 30 mins. All while their waiting room is filled to capacity with clients who have developed high blood pressure from the stress.

It's rather obvious that anyone who is against change wants it all to be picture perfect and labeled with all the necessary numbers that will tell where each dollar is going. The politicians are aware of is going on and it's not about conspiracy, it's about keeping a job that no longer has any merit. Anyone can say what they will about what has to be done yet it isn't getting done.

[Ember]

Who is this guy, and why should I listen to what he has to say about healthcare reform?

[standard]

Point well taken. You shouldn't!

Montana evidently lacks a serious acquaintance with this subject, a command of the relevant facts, or an understanding of the term "socialism". He compares Keith Olbermann, a master of facts and reasoning and a graduate of Cornell, to Sean Hannity, a college dropout (like Limbaugh and Beck) who (like them) promotes fear, anger and ignorance in lieu of addressing facts. Montana seems more a poseur than a pundit. Hubert Humphrey once said, in a moment of extreme clarity, "The right to be heard does not automatically include the right to be taken seriously," words that Montana would do well to ponder.

[TheKurgan9]

So because Olbermann attended Cornell and Rush dropped out of college because he felt it was a waste of time Olbermann is more intelligent?

Newsflash - Bill Gates dropped out of college. So did Steve Jobs. They felt, like Rush that college isn't going to help me get to where I want to go...and guess what, all of them, including Sean Hannity are extremely successful­....more so than Keith Olbermann.

I attended Columbia University (a few notches above Cornell...­supposedly­) and I can tell you right now that some of the most foo lish individuals I have ever met came from Columbia. Just because you attended an Ivy League school doesn't make you intelligent or successful.

[Peabodies]

Wait a minute, Mr. Montana (you look young in your photo) -- you state "All you have to do is walk in and apply. Also, in case of an emergency, there are EMERGENCY rooms in every hospital and they CAN NOT deny you care".

What you leave out is that emergency room care is the most expensive care. If the patients had had a regular physician who helped them get better before it got to be an emergency, it would be better for the patient, of course, but it would also be cheaper. Another thing you leave out is that the bean counters at the FOR-PROFIT hospital where such emergency care is administered will HOUND the patient for the cost of the extremely expensive care they received, perhaps causing them to lose their savings, home, even bankruptcy. Is this an acceptable cost to society for NOT HAVING a decent, fair, universal system of illness prevention and health maintenance? The rest of the world treats health care and illness prevention as a human right. Why does it have to be a for-profit, employee-servitude, unaffordable system in ours? This is truly unsustainable, and it HAS to change.

[BarryS]

If I hear you, we should ban All socialized medicine in the USA. OK, Obama and his kids have to go to a clinic in DC for care, adulterous GOP senators have to go to DC clinics to get a shot when they contract VD.

But best of all send CIGNA and UHC to IRaq, because military medicine in socialized. Tell your parent [grandparents] no more medicare. No more VA hospitals.


Do it tomorrow.

-or- just give me what they get at their cost.

[FearlessFreep]

Two words: single payer.

[standard]

One word: amen.

[Patrick Yaeger]

Nelson Montana doesn't seem to follow closely what's actually going on with health care reform or what President Obama is doing to shepherd that reform. While Montana's post reflected hubris, confidence and certainty, it didn't reflect depth of knowledge, insight or the actual current state of health care reform working its way through Congress.

[quidam56]

As a former health care giver, I am shocked and saddened to see what has become of health care in America. $ 1. 4 million is being spent per day in DC by the health care lobbyists so your elected representative is getting taken care of and has quality health care we pay for and can't afford ourselves for our families, I know what is deemed, defended and supported in Tennessee and Virginia as quality health care and clearly profit care comes ahead of patient care. http://www.wisecountyissues.com/?p=62 MRSA ( methicillin resistant staphylococcus aureas ) is infesting our communities because filthy, uncaring hospitals and emergency rooms are breeding them and spreading them into our schools, homes, restaurants. How many more Americans' will be diseased or die while 74 % of Americans' are begging for health care reform ? More people died in America last year from MRSA complications than AIDS. When MRSA and a flu bug start mixing, it won't be pretty and we are being infected by the very health care system we depend on and trust to keep us safe and healthy.

[SeriousBlack]

I don't even know where to start here.

"the loudmouths on both sides, be it Sean Hannity or Keith Olberman"

I almost stopped reading your article right there, Mr. Montana. If you are SERIOUSLY going to try to make those two individuals somehow equivalent to each other in terms of the issues that they address and the truth and logic of their arguments, then... (shaking my head in disbelief).

But I made myself keep reading for some reason. Maybe I just had too much time on my hands this afternoon. But to keep from agitating my carpal tunnel too much, I'll only pick out ONE of the comments in the remainder of your article.

"Also, in case of an emergency, there are EMERGENCY rooms in every hospital and they CAN NOT deny you care. "

Yep, they can't deny you care. And when that care is over then you start getting the tens of thousands of dollars in bills that you can't afford to pay and when you get worn down by the collection agencies calling you 50 times a day you finally have to declare bankruptcy.

[standard]

The fight to establish a public health insurance option this year has only just begun. Most Americans want that battle fought, you're clearly not in our corner, and yet you want to throw in the towel for us. Well, no thanks!

"Real reform can only come from a socialized medical system . . ." ? No way! All our health care providers do NOT need to become Federal employees (as in ACTUAL socialized medicine). We simply need insurance companies to stop being unneeded middlemen between average Americans and our physicians and to separate being covered from being employed and having no pre-existing conditions. Eliminate the billions in annual profit that middlemen make selling us high-cost insurance--but no medical services--and we'd have a lower-cost system that's more effective--and without nationalizing anything.

You're quite good at mixing metphors (really!)--but please (please!) leave public policy analysis to actual policy wonks who know what they're talking about.

[Romulus]

I don't think the problem lies ONLY with the insurance companies. I just had a colonoscopy at the local hospital. It was an outpatient procedure. I was in the hospital facilties for about four hours. Besides the doctor and his staff, there were three or four hospital employees involved in prep and recovery.

When I received a copy of the bill, I was shocked. The hospital bill alone was $3194.18. That't not counting the doctor and his staff. Fortunately, I have Medicare so that was not a problem. But here's something interesting: The hospital gave Medicare a $2486.46 discount. That reduced the bill to $702.72 THAT seems like a reasonable about to charge for the services I received from the hospital itself.

Medicare drives a hard bargain with hospitals and doctors. If I had a private health insurance plan, they probably would have paid the entire amount, allowing the hosptial to rip them off. In turn, the insurance company would have to rip off the customer in order to cover these outlandish prices that hosptials charge. And that's not even considering what the doctors charge.

[standard]

I appreciate your comment and I agree that cost containmen­t--includi­ng returning the practice of medicine in general to being a professional service first and a business second--is also necessary. Step one, however, has to be breaking the insurance companies' stranglehold on unimpeded access by all Americans to medical services.

Remember: part of what that original invoice contained in its inflated prices was the cost to the hospital of treating several uninsured or underinsured people in its emergency room. The price to Medicare came closer to the actual cost to the hospital of the services rendered just to you.

[pianoteacher]

Um, you're kidding, right?

[NickHP]

Socialized medicine. Sure. But making the clinics be the providers seems to bankrupt us as cost trends aren't improved. We'll still need electronic transferable records and computers at every office so the current doc can see all our data.

The Swiss had the best approach - cover everybody and then worry about costs later. If we can pay for a war, we can pay for medical care.

(One thing about the Phillip Morris reference - it's more than a bad decision on the part of the smoker, nicotine is addictive, and hits the brain at a low automatic level not involving conscious decision making)

[classicalgeek]

In addition, cigarettes are heavily advertised to those least capable of making informed decisions, and having the least resistance­--teenager­s. The tobacco companies add other addictive substances to the tobacco which enhances the addictive quality. I've even seen people become addicted from breathing second-hand smoke.

Also, you can trash the choice to eat at McDonald's all you like, but the fact is that in poorer neighbourhoods, often there are no decent groceries (just convenience stores) and fast food is sometimes the better choice. Try working at McDonald's for minimum wage and getting your meals at half price, plus having only a 20-minute break for lunch, and see how motivated you are after eight to ten hours on your feet, to go home and prepare a nutritious lunch to bring with you the next day, when there's no way to heat it, and your boss won't let you store it in the cooler. McDonald's may be healthier than eating what's available at the gas station, or risking bacteria growing in your food while you wait for your break.

[mamacita]

And pharmaceutical drugs are also advertised to those least capable of making informed decisions. Cigarettes were banned from advertising on television, and the same should apply to prescription drugs. Ask your doctor....­phaaak!