Newsweek's Jonathan Alter: Conservatives Need to Stop the 'BS' of Calling Obama's Plan 'Socialized Medicine'

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Left-wing talk show host Ed Schultz guest-hosted MSNBC’s 1600 Pennsylvania Avenue on Tuesday night (could it be a tryout for that fourth spot in the ultraliberal MSNBC evening batting order after Maddow?) In one interview, Newsweek’s Jonathan Alter reminded all conservatives of a certain age how eager he is for socialist health care, just as he was for Hillary’s plan the last time around. The first symptom? Deny the reality in front of everyone’s face, that somehow he and the Democrats don’t favor having the government run everything:

ALTER: First of all, nobody‘s talking about a government-run system. As John Podesta just indicated, if you‘re happy with your private health insurance, you‘re going to be able to keep it, no matter what comes out of this Congressional process. We need to stop stigmatizing, the name calling, the socialized medicine, the government-run programs. All that is just BS. This is—

(CROSS TALK)

ALTER: This is about a compromise that‘s going to offer a lot more choices. It is going to be expensive. But the question is whether it‘s more expensive to have the status quo. And health care experts on the left and the right believe that to be the case. That‘s why we‘re ready for change.

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"Health care experts on the right" are not going to favor a more-government solution, so Alter should cut out the pretense that Obama’s going to generate some "purple" compromise on health care. Once again, the liberals get angry when someone starts calling it socialism, no matter how comfortably the shoe fits. He sounds like a Fairness Doctrine kind of guy when he insists "We need to stop letting the other side call it something stigmatizing."

Alter doesn’t want to acknowledge that countries with socialized medicine don’t offer "a lot more choices." Governments tend to restrict the amount of choices – which is why their patients come to America instead of waiting in line for months or years.

Earlier in the interview, Alter was clear in his opinion that government was more efficient than those private insurance companies:

SCHULTZ: Jonathan Alter, can President Obama get bipartisan help on this to get something done this year?

ALTER: Yes. I do think you‘re going to see health care legislation this year. Just to correct something Lars [Larson] just said, you know, it sounds counter-intuitive that the government could do anything right. We‘ve just been through a 25-year period where the ruling ideology was if the government does it, they must be messing it up. Actually, if you look at the history of Social Security and Medicare, runs much more efficiently than when the insurance companies take their huge cuts of all this.

Jonathan Alter is "idealistic" enough to think government somehow doesn’t take "their huge cuts" out of health spending. Anyone who wants a clear idea of Alter’s views on insurance companies should see his quotes from the last time around: he wants them put out of business.

Alter won our "Dr. Kevorkian Award for Health Reporting" in 1993 for this doozy in a Newsweek column:

"But Hillary was smart to rip their heads off....After all, she's right substantively: the [health insurance] industry has `brought us to the brink of bankruptcy,' it does `like being able to exclude people from coverage, because the more they exclude, the more money they can make.' No other industrialized country puts up with useless paper shufflers taking such a large cut of their health budgets...And she's right tactically: if health-care reform is to live, the companies backing Harry and Louise must die. If 90 percent of those 1,500 insurers don't die -- if someone lifts the DO NOT RESUSCITATE sign off them -- then the entire reform contraption will collapse." -- Newsweek media critic Jonathan Alter on insurance industry's "Harry & Louise" ads, November 15, 1993.

—Tim Graham is Director of Media Analysis at the Media Research Center.


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Why would anybody do that?

... call it socialized medicine. Obama IS SOCIALISM.

So wait, does that make it socialized medicine? Why yes I belive it does. 

Obammunism, works for me, maybe he likes that better.

They just pretend it's

They just pretend it's not.

Kind of like their description of "a procedure that opponents call partial-birth abortion" (They would have us believe it's inaccurate to call it that.)

I didn't think it was physically possible, but this both sucks and blows. -Bart Simpson

He is just another

He is just another "journalsit" that is full of crap. If it is not socialized then what is it? I don't agree that Medicare runs that great. There is a lot of fraud there. as far as MSNBC goes they may have had 200,000 viewers that hear this crap. 

Freedom is never more than one generation away from extinction. We didn't pass it to our children in the bloodstream. It must be fought for, protected, and handed on for them to do the same. RWR

I find it strange. . .

that every economist--liberal and conservative--recognize that Social Security and Medicare are going to crush us within 20 years and Alter uses these as paragons of efficiency.

Absolutely, and you want a mess?

If one thinks the mortgage mess was expensive, then give a health debit card or HSA to the most sedentary, obese, and (currently) coddled society in the history of humankind.
2006---2.5 trillion health bill
2010 "healthplan" for all---likely 5 trillion each and every year

Those of us in the medical field can only laugh at the idea of "leaders" promoting paying for all treatments over self-responsibility (Imagine a REAL leader:  "you want good health, then lose 50 pounds and exercise!").

Here's an idea:
Government health "insurance" to any and all adults with:
BMI under 25, verified annually
truth:
smokers still welcome, since they die younger and and avoid nursing home  costs at 40k per year

Yes, let lawyers decide and health coverage, like SS, Medicare, and mortgage.......good luck to us all.

AMEN!

You can't use BMI.  You can be 5' 10" and 210 lbs of pure muscle, and have a high BMI.  How about going by body fat?  How about 25% for men and 35% for women?

I do agree that responsibility needs to pay a larger roll in defining health care.  If the government wants to run the system, then it needs to do a lot of work looking into reducing disease instead of treating it after the fact.  Exercise and weight control would go a long way in reducing medical costs.

Can't go by body fat either.

Body fat levels based on physical measurements are wildly inaccurate.  

Just ask any military member (like me) who was consistently measured by such 'one size fits all' standards as 'overweight' and even 'obese' despite a daily PT regimen of running 4-10 miles per day, calisthenics, and routinely scoring 'Outstanding' on semiannual fitness tests.

The only reasonally applicable and accurate method of measuring body fat is total submersion.

                           -------------------------

And what is a person to do if he or she is so morbidly obese, or hereditarily overweight, that medical intervention is essential to comply with such arbitrary standards?

How and by whom will a person's diet or lifestyle be deemed 'unhealthy'? Who follows us around to make sure we don't sneak a 'smoke' or a 'Big Mac' lest we lose our 'good lifestyle' discount?

Will our neighbors be allowed to turn us in if we're seen unloading Baskin-Robbins ice cream from the back of our SUV? Will there be rewards for such public spiritedness?

Obama is known to smoke cigarettes. No doubt there are Members of Congress who smoke. Many of Obama's healthcare bean-counting bureaucrats will be smokers. Will their lifestyles be deemed 'unhealthy'?

Would having a limb amputated due to complications from diabetes reduce the patients total weight to an acceptable level for governmental approval for treatment? Would the loss of both feet be acceptable to Obama's minions in lieu of the surgical amputation of a single leg?

What about patients prescribed medication with side effects including significant weight gain?

How about para- and quadriplegics? Would a knee or hip problem excuse an inability to perform physical training in the eyes of Obama's health care bureaucracy?

Would child care be provided during exercise? How about employer-funded fitness club memberships? Or does our Dear Leader intend to simply line us up across the nation in front of huge screens or loudspeakers while he calls out cadence from his teleprompter?

Could a pregnant woman surpass such body fat standards as her term progresses, making herself ineligible for continued prenatal and even maternity care? How long would she be allowed to reduce after childbirth?

To which bureaucracy do we appeal the unfavorable decisions of this bureaucracy? Is such an appeal process even contemplated?

And do you trust the government to answer these questions, and a thousand more like them, from their ivory towers in Washington?

NOLI PUGNARE ME OCCIDERE

there are always exceptions

but my point remains the same.
BMI's are an accurate reflection of one's size, but no level of disease or disability means one has to keep cramming calories down the piehole.

One need simply walk the streets of Paris or London to easily id the Americans, and it is our fatness.
Again, I dont advocate for a  national health "insurance" (again totally raping the word insurance), I just advocate for leaders who speak the truth:  Americans are too fat to be deserving of a national plan to pay for health costs.   What is the point for the remaining 25% of adults to keep thin, and thus not diabetic, sleep apneic, not HTN'ive or needing new joints, etc etc....

Read my post and see how complicated the 'fat' issue is...

 ...Even if your claim is true, it's not for you to sit across the pond passing judgment on our lifestyles.

If you don't like it, tough. I don't give a damn what you think.

I listed about a dozen different situations, some farcical, some serious, that prove that denying care based on BMI, body fat percentage, or any other single standard is dangerous and impossible.

Britain's NHS is seriously considering denying treatment based on 'unhealthy lifestyles' which means just about anything they want it to mean.

Rather than increase funding to match patient demand, the NHS is rationing care based on arbitrary criteria like 'fatness' and 'smoking'.

This appeals to people (like you) who are already led to believe these types of people are second class citizens undeserving of care.

This is often literally a life and death issue for those unjustly denied care. This is also of no concern at all to a state run health system that cynically and routinely sentences its citizens to death to save a few pounds, dollars, etc.

Who is denied care for 'unhealthy lifestyle' the next time NHS funds run low? Motorcyclists? Parachutists? The military?

Will the NHS use DNA which can now determine with some reliability one's potential to develop cancer, bone or other diseases?

Will they deny care to a child in the nursery based on DNA results? Or will they simply 'terminate' the child under elastic euthanasia policies such as Holland's?

Citizens in any nation who don't rise up and revolt against this statist outrage will find themselves similarly decreed as 'undesirables'.

And people like you want to punish America with this vicious and failed healthcare tyranny. It's obvious in your own words.

NOLI PUGNARE ME OCCIDERE

Tailgunner

You have some very interesting comments on "nationalized health care"....you may wish to join us over on the Forum threads....we've been having a rather detailed discussion of our health care system there, and I suspect you'd have some salient points to make.

 

I hope he fails, too.

 

 

I couldn't hold a candle....

...to the intelligent and accomplished posters on that forum.

Besides....'no trolls allowed'?

What is living without demolishing trolls?

Thanks for the invite, anyway...;)

(Seriously, I'll bookmark it and return.) 

NOLI PUGNARE ME OCCIDERE

Not to mention BMI

Not to mention BMI standards have been changed arbitrarily over the years, making millions of "overweight" people "obese" literally overnight.   And Obama has already stated his dedication to eradicating fat people, as though he knows anything about it.

"you want good health, then lose 50 pounds and
exercise!"

That kind of advice has killed far too many people already, given by malinformed doctors who think fat people's medical problems are a matter of fat and don't even stop to listen for a minute what is actually going on, and make the false assumption that they are just stuffing their faces and sitting on the couch even if they are told otherwise.  Despite the fact that "calories in/calories out" is nonsense, as the vast bulk of the processes involved are **involuntary** functions and the equation is actually far more complex when those functions are taken into account.

 http://junkfoodscience.blogspot.com/2008/10/first-law-of-thermodynamics-in-real.html  http://fathealth.wordpress.com/about/   http://www.nytimes.c...

"Here's an idea:
Government health "insurance" to any and all adults with:
BMI under 25, verified annually"

How about not?  Federal involvement in health care is unconstitutional to begin with, first of all.  Second of all, that's the standard?  Much less the only one?  (Not to mention it's ridiculously low.)  That makes as much sense as saying no one over 5'11" - tall people are disproportionately affected by a variety of health problems.  It's as sensible as suggesting that anyone whose family has a history of high blood pressure has to be excluded.  You'd do better to exclude the underweight and include the fat, because of the first "Obesity Paradox" (of which there are so many it's not a paradox anymore) - which is that the overweight are far more likely to survive heart attacks and the underweight far more likely to die when they have one.  Morbidity rates just don't match the "common knowledge" or the hysterical reports.   Then there are at least 12 other similar "Obesity Paradoxes" to go through.  You better eliminate anyone who has a family history of all manner of health issues and leave the weight aside, and that includes the diabetes.   For the info on all the paradoxes, there is an entire series of them on this site: www.junkfoodscience....   

I'm not attacking you, but there is really nothing funny about this issue, and the stunning amount of misinformation that gets spread about it is extremely frustrating.   Fat people have been blamed for everything from global warming http://www.fatmanunl... to causing their friends to get fat even if those friends live thousands of miles away, to causing world hunger and food crises http://news.bbc.co.u... .  At some point this madness about people's body types needs to stop.   You can not tell a person's health or vitals or habits or diet by knowing their weight, their BMI (extraordinarily simplistic and meaningless), or their body fat percentage, their waist-to-hip ratio, or how their hair is cut.   The science keeps coming in and discrediting these notions, and the media continually distorts or outright lies http://junkfoodscien... about the statistics, the studies and the results.  

 

The finance model

The current healthcare system is run by insurance companies. Their finance model is simply a wager, laid off across the spectrum of premium-buyers. The bet is that the premiums paid (which insurers re-invest to multiply the return) will be greater than the costs of delivering care. The dynamics are the same as any other bet, except that the bettors are actual participants in the game. As it is, the bulk of the care is disproportionate to older users, and the cost of elder care is growing disproportionately itself.

If you take the finance away from insurers and use government resources, you're still doing the same thing. You're spreading the cost to the taxpayers. The difference is that insurers spread the wager across the pool of premium-payers, who are (by definition) working people who pay money into the system. The government spreads the wager to the whole population, where a huge chunk of them aren't working and don't contribute. 

To be clear, the fact that they're not working shouldn't be considered a moral strike against them. But it does mean that when you add them into consideration, much more care is required overall, only with the same number of paying contributors.

The cost to each paying contributor (i.e., each taxpayer) will skyrocket.  

Alter's deception is obvious. He's offering the government as an alternative financier. But if your intention is to change healthcare overall, you're hoping that the government alternative attracts people away from private insurers to public programs. What Alter isn't telling you is that as that transition happens, it changes the dynamic. When you have more people in governent programs, you'll need more tax dollars to fund it. Tax-paying citizens who remain with private insurers will still have to pay for the government system through their taxes. Like Catholic school parents, they'll just be paying twice. That, alone, will drive them to the government program.

The difference is that even though it's presented as an "alternative," you're paying for it anyway. The only alternative is whether you wish to pay twice.

House Always Wins

I like your analogy of private insurered healthcare as a wager.  I would go further in defining the "game".

Healthcare insurers not only set the rules of the game, they also are able to hid aces up their sleeves and can change the rules in order to safeguard their win.  Using the latest in actuarial tables, morbidity and mortality trends, and a vast array of bean counting accountants and attorneys, the private insurers odds of losing are slim... unless there is true competition from other private insurers and the legislative and judicial branches of the government to keep them in check.

Wealth made by those in the insurance biz is staggering for doing something that produces nothing, only shuffles paper around.  The InsurCos in essence perform none of the work, provide none of the goods except for accepting or denying requested goods and services.  They are merely expensive middlemen that connect two parties in a business transaction, but only if the transaction is fiduciarily responsible for the InsurCo and their investors.

The odds are in the InsurCos' favor.  Why else would anyone go into the business unless they would make money?  The main hurdle is having enough capital to cover a percentage of claims per number of insured in order to satisfy government licensure procedures.  After that, the trickiest issue is providing services in the context of guestimating when you can say "DENIED" just enough to make profit while not angering clients to seek insurance elsewhere.

Yet, this is a preferrable model to Socialized Medicine!

→ Gambling on health

Most people have trouble grasping the game theory of insurance because the bets are switched in their outcomes.

I buy insurance, betting I will "win" with an unfavorable personal outcome.  I win with a wreck, illness, or death. 

Insurance carrier is betting none of these will occur before they have accrued a payoff for the event.

Obama is succeeding and it hurts

The government wager

"Wealth made by those in the insurance biz is staggering for doing something that produces nothing, only shuffles paper around." 

Well, is that really true, stratman? The insurance company pays the costs. That's not beanbag. They pay for the whole thing.

They do it by taking risks, and limiting their exposure as much as possible. Now, insurance companies limit their exposure in often unfair ways - no argument about that from me. But consider the risk involved. They're shelling out a lot of money.

Now, remember, there are other factors involved. The doctor's range of treatment is expanded by the progress of technology, but that technology comes at an increasingly larger cost. A new heart procedure may save a lot of people, but it costs a fortune. More and more of those technologies are coming, and they're all expensive. (You know what's paying for all those now? Viagra.)

It's a hard fact to admit, but the only thing restraining that explosion in cost is the insurer's profit motive. Insurers won't cover most of the expensive procedures, which serves to limit them.

Knowing all that, imagine what happens when the program shifts to the goverment. And, worse, imagine what happens if we treat healthcare as a right. There is no longer any restraint, because government will cover it. Suppose you're 85 years old and smoked Luckys for years, and now you have emphysema. If a treatment becomes available, no matter how expensive, the pressure will be for government to provide it because it's a right. The collective cost will skyrocket.

InsurCos Provide Valuable Service

 They pay for the whole thing.

 They're shelling out a lot of money.

InsurCos use our money to pay the bills.  That's the deal.  They have actuarial tables that provide them with an advantage in predicting costs so that the fund of money available will cover the outlay for expenses.  They may be shelling out a lot of money but there is plenty left over as profit.  There is no Mother Teresa working/owning the InsurCo.  They are not our parents who would choose to go with less so that we, the child, could have more.

I initially wrote opinion supporting the above, but on further reflection, InsurCos do provide a service beyond the payment of bills - the provide medical advice.  This is a contentious statement, one that InsurCos deny since it would make them liable for poor outcomes like the actual treating physician.  Precertification for procedures, choice of pharmaceuticals, the protocol followed in diagnosing and treating illness and other aspects are all under the watch of the InsurCos, some to a greater degree than others.  The InsurCo representative your physician or their office speaks with may be a 20-something non-medical person who merely reads from a script what may or may not be allowed.  One may appeal and eventually speak with a physician working for the InsurCo, but he/she will never claim they are giving medical advice despite deciding what is appropriate for the patient, someone they have never seen nor examined.

Now, InsurCos base there decision trees on medical principles as well as actuarial tables.  My opinion is that making a decision on what care is covered is making a medical decision,  If InsurCos were responsible as medical decision makers then the insurance industry would change remarkably and it would be more expensive.  Same would be true if InsurCos were required to provide all available care including evidence-based, alternative and complimentary-based, and experimental-based care - they would go out of business. 

Rationing is already here and will increase if government takes over all healthcare insuring/providing.  Since the pool of insured would then include paying as well as non-paying persons, the actual fund of money available for payouts per person would be less overall.  The only way to remedy this would be to charge more in taxes, cut reimbursements, and/or rationing care.  I expect all three to occur under Socialized Medicine.

To paraphrase the Mexican bandit leader Gold Hat in The Treasure of the Sierra Madres:

Rights?  You don't got no rights. You don't need no rights! I don't have to give you any stinkin' rights!

Here's a clip from the original movie.  If Obama has his way, we are going to feel a lot like Fred C Dobbs (Humphrey Bogart).

BTW, nice Lucky Strikes reference!  Don't hear that brand mentioned much.

 

InsurCos use our money to pay the bills.

Excellent point. You're right.

Don't get me wrong, strat. I don't want to defend the insurers. But the payment system is the problem. We have to find a way to finance the system that doesn't automatically spiral out of control.

You're playing to my weaknesses, by the way. Cagney remains my favorite, with Bogart close behind. They just don't make 'em that way anymore. And the Luckys? I don't even know if they're around anymore. But that's what you smoked if you wanted no one to bum cigarettes off you in high school. (Don't worry, I quit many years ago.)

I accept the role of the

I accept the role of the InsurCos.  I don't see a wholescale return to fee for service where there are no third parties, unless there is some calamity and our socioeconomic order has collapsed.

The delivery and practice of healthcare in America are superb.  That individuals do not avail themselves of healthcare, for whatever personal reasons, is not the fault of healthcare. 

The three points of contention seem to be is whether everyone has a right to healthcare, what the cost of that healthcare should be, and how healthcare shall be paid for.  The driving force behind all of this is the expectations of the American public as shaped by the media, politicians, special interests groups, and physicians.

What do you suggest as the way to finance the system?  Is capitalism, using competition and economies of scale purchasing power, no longer viable as the vehicle for containment? Or, is statism, using an autocratic Health and Human Services Dept or Health Czar, the method?

Maybe the way to go is further re-integrate the obligation of the consumer into the cost of healthcare.  Healthcare insurance that requires only a paid premium dislocates the insured from the total cost of their care.  When something is perceived as paid for no matter how much is used, like a single priced, all you can eat buffet meal, then more will be consumed.  This has been the thinking that led to the requirement for patient co-pays, spenddowns, Medicare Part D doughnut payments, etc.  By continuing to pass on costs directly to the cunsumer/patient, the patient will not seek frivilous care... at least that's the thinking. 

Unfortunately there have been competing forces that hinder the desired outcomes.  One problem is that people have come to expect certain transactions and outcomes from medicine and insurance.  This is the cultural issues that have been spurred on by the entities listed above.  It will take a willingness on the population and several generations before accepting a different paradigm (unless there is a "crisis" which ,as we know now, should not be wasted).  The other issue major issue is that when people are faced with paying for healthcare versus daily living issues (food, electricity, etc), people will shortchange their healthcare.  Both result in an alteration in healthcare.  The difference is the former is by governmental fiat and the latter by individual choice.  One is statism and the other respects liberty. 

I posted a response to TN Mom below in this thread which dovetails somewhat with our discussion.  Later on, I was talking with my mother about the post.  Her first response was that healthcare was her "right" because she had paid into the system and deserved comprehensive care.  Ironically, Medicare was supposed to be a "supplement" to the primary healthcare insurance one received from their job or purchased on one's own.  Nowadays, Medicare is viewed as the primary insurance, oftentimes with no other insurance available.  The expansion of Medicare's coverage was not only a product of well meaning politicians but also the byproduct of our culture's advancing expectations on their "rights" propelled forward by a changing employee compensation model.

One thing I believe is certain is that Socialist Medicine will require a significantly decreased expectation by Americans concerning their healthcare due to rationing and having less money available to spend on other things due to an increased financial obligation to pay for universal healthcare.

--------------------------------------------------------------------------------------

Had to laugh at your smoking references.  Grandfather smoked unfiltered Pall Malls or Kents.  Those were nasty.  I started out with Camel nonfilters.  Only the desperate would bum one of those. 

I'm curious

Are doctors the only profession where you don't pay the provider of services? (OK, prostitution pays the pimps.) Anything else? 

You said here - "I don't see a wholescale return to fee for service where there are no third parties, unless there is some calamity and our socioeconomic order has collapsed." Earlier, you said that doctors weren't allowed to collaborate under anti-trust laws.

I'm now sitting back and asking, "why is that?"

I'm sure there is an obvious answer, but at this moment, I know that I couldn't explain it. Why?

→ Factoid?

Why is it that Lawyers and Doctors "practice"?

Does your mechanic "practice"? 

Obama is succeeding and it hurts

Excellent Question

What exactly constitutes the practice of medicine is an important legal/safety issue.  By knowing what is the practice of medicine, one may know what isn't the practice of medicine.

 

NYTimes Feb. 6, 1906:

COURT AT LAST DEFINES PRACTICE OF MEDICINE; Any Act with a View to Relieve, Heal, or Cure.

 

American Society For Dermatologic Surgery:

DEFINITION OF THE PRACTICE OF MEDICINE
The practice of medicine involves diagnosis, treatment, or correction of human conditions, ailments, diseases, injuries, or infirmities whether physical or mental, by any means, methods, devices, or instruments.

 

Collège des médecins du Québec:

Definition of the Practice of Medicine
Under the terms of the Medical Act, the practice of medicine is defined as follows:

"31. Every act having as its object to diagnose or treat any deficiency in the health of a human being constitutes the practice of medicine.

 

Satirically put, the practice of medicine is what you get if hospitalized in a teaching hospital during the month of July, the month when first year residents begin inpatient training.

Are doctors the only

Are doctors the only profession where you don't pay the provider of services?

I can't think of any off the top of my head.  Prostitutes are employed ("owned") by their pimps, so any payment that goes to the pimp first is still to the "provider" of services.  Then I thought of slaves, but their owners are paid for services rendered, similar to the pimps and hookers scenario.

Maybe temp workers are similar to the physician's situation since the temp's services are paid by a middleman.

Fee for service in this context refers to the good old days where a physician charged a fee directly to patient after providing healthcare services.  The patient was directly responsible for the fee charged.  No middleman (InsurCo) were involved.

There are a handful of physicians that eschew InsurCos and have returned to traditional fee for service.  I don't see physicians en masse shunning InsurCos and returning to old business practices unless there is some sort of calamity.  Maybe Obamacare will be the beginning of a calamity, though I don't think it will be enough inducement on its own.

Concerning anti-trust laws, non-unionized physicians can not group together for purposes of contracting with InsurCos unless they are all part of the same group.  I cannot ask another practice's physician what he charges, is reimbursed, or any other contractural issue.  I believe that Federal law prohibits the sharing of specific data between individuals or groups of different practices/businesses.  It is legal, however, to learn of aggregate data for your area, such as average fee schedules, and information businesses charge an arm and a leg for that data.

I imagine the reasons for anti-trust laws in this area are the same as for any other business that could conspire with a competitor to fix prices for consumers to increase profits, squeeze suppliers for lower costs, or cut prices to run a third competitor out of business.

As I've been told, the government loosened anti-trust statutes for medical insurance companies post-WW II to facilitate medical care for a people who won a war and now were busy producing prosperity in the country.  How much of this decision was part reward for winning the war, part "feeling good" about ourselves, part offloading cost of GI Bill medical care to private insurers, part promotion of a new/fledgling industry (influenced by the good-old-boy network), etc. is debatable.

Part of the problem today is that InsurCos currently have an unfair advantage - they control the purse strings, especially when they have market share over the competition or control a desirable population of patients deemed important to one's practice success.

While InsurCos that gobble up other InsurCos to become Goliath InsurCos are important in obtaining economies of scale, hopefully lower premium costs, the downside is that the supersized InsurCos gain larger and larger market share, decreasing competition, and disincentivizing the InsurCo from not raising patient premiums or cutting physician reimbursements. 

When you're the 800 lb. gorilla, who's going to mess with you?  

Generally speaking, the gorilla tamer is the government and the courts.  How much the whip gets cracked is the question.  So far, government and the courts have upheld the monopolization of market share by fewer and fewer InsurCos.  How often have you read about a healthcare merger that was not allowed if the financials were in order?

Thanks, strat

There's a lot to think about there.

My first instinct is to wonder if these rules were created in an envionment where there are relatively few doctors. After all, conspiracies only work when there is a scarcity. Ain't no scarcity of doctors.

My perspective might be warped because I live in Baltimore. It's the sickest city in America, because of all the doctors from Johns Hopkins. You can't walk ten feet in this town without tripping over a doctor. I can't imagine anyone carrying off a conspiracy here, because there are so many alternatives.

I don't know. Something seems fishy on those assumptions.

KC: I don't think I

KC:

I don't think I understand what it is you are getting at.  Could you elaborate on your thoughts and suspicions?  I don't recall discussing a conspiracy per say. 

Maybe a little collusion between government/insurers and physicians/insurers, but not a conspiracy.  ;-)

Could the physician-insurer relationship be related to the heroin business?  Initially, insurers and physicians were willing collaborators.  Insurers, acting like heroin dealers, provided a desired product - guaranteed reimbursement with fewer hassles, AKA pure heroin.  Physicians were not only customers, some were also financial backers of the product.  As time passed and market share grew, the heroin dealers began to cut their product strength and raised prices (rejected/bundled claims and lowered the overall amount of reimbursement to physicians).  The physician/junkie knew he was getting lesser product but every other dealer in town was doing the same thing.  He was hooked with no easy way out.

Sure, a dealer might value-add his heroin to capture more market share (give better reimbursement) but every dealer eventually screwed the junkie.  Junkies do not want to destroy their supply line even if the dealer is ripping them off.  Junkies used to grow their own drugs (use no InsurCos for fee collection) but long gave it up because it was easier for someone else to deal with the hassles.  Besides, the dealer's heroin was good, plentiful and attractively priced initially.  

Junkies will not stand up to the dealer to improve their lot for fear of losing their fix (reimbursement).  Going to the authorities is complicated and often costly, a risk most avoid unless desperate.  And methadone (Socialized Medicine) doesn't sound like a substantial high (even lower reimbursement) and "the man" tells you what to do and when to do it... or else no methadone.

That's all I have so far on the doctor's as junkies allegory.

 

 

I have some concerns

 Is this Alters opinion, or is this the WH trying to quell the notion of socialized health care? After listening to Gibbs, and learning the tactic, I am simply not sure.

 

"Television is a freak show" Bernie Goldberg

How many times did BarryO

How many times did BarryO (and Biden) scoff openly at the notion that there was anything "socialist" about his plans?   He went so far at one point as to say he wouldn't have **time** to take a hard left in policy so people shouldn't worry.   Last time he was honest about his socialism was in one of his books, where he said he chose his friends **very carefully** (Ayers and Wright and Khalidi included one would conclude) and proceeded to list "Marxist professors" among them.

My point being that it doesn't matter much if someone told the guy to say it or not, because he's made it clear to the media that they have to downplay the word socialist and call it something else - just like the "Fairness Doctrine" and the "Employee Freedom of Choice Act" - both named the opposite of what they really are.   

America, you're getting scammed.

One of the greatest delusions in the world is the 'hope' that the evils in this world are to be cured by legislation.

-- Thomas Brackett Reed

Coverage

Health Insurance Companies are defrauding patients and their Dr.'s alike. I've been in practice 29 yrs and have NEVER seen the fraud as bad as it is now. The average Joe may pay for 80% coverage, but he will be damned lucky if his Ins Co pays 40-50%. In reality, most people are better off not having the cost of the insurance taken from their checks. I and my patients have been cheated by the co's to the tune of  $250,000 in 2 yrs. One Dr in a small town. Like the Bank Bailout, the Insurance  bailout rewards crooked co's with the money taxed from the very people they defraud. In effect, taxpayers are paying these co's to cheat them. Aint bribery wunnerful????

Fix the Problem, First...

If what you say is true then there's a lot of $ to be saved by clamping down on system abuse. In fact, if it were substantially reduced that might add up to more savings than the supposed savings of Barkey's plan.

Socialize Health care, for a Better Economy?

Sure, let's hand health care over to the federal government. That will fix the problem, NOT!

You think you're getting cheated now? Wait until Obama takes control: "Specifically, Obama's health budget calls for significant cuts to payments the government makes to health insurers, hospitals and physicians."
Source

Once Heath Care is "nationalized," you won't get paid at all!

The Citizens of each State shall be entitled to all Privileges and Immunities of Citizens in the several States.
The US Constitution

Unless you're a fetus.
The US Supreme Court

→ It's happening Cobra

Look at the gigantic Merck & Schering Plough merger.

In a time when it makes more sense for the monsters to gobble up the little guys, it's starting to look like they're forming even larger conglomerates in order that they might stand up as equals to this system.

Roche gobbling up Genentech?  I think we're seeing the GE model at work, where the Government has its pet companies playing for all the marbles in a socialist economy.

Obama is succeeding and it hurts

"Once Heath Care is

"Once Heath Care is "nationalized," you won't get paid at all!"

Not to mention that it's written into the stimulus bill that doctors have to report every visit to the feds so they can figure out where they're going to have to make the cuts.   Then they'll cap a Dr's visit to $5 or $10 a piece, cap the treatment and prescriptions, and maybe never pay.   Once the inflation takes effect, that $5 will be worth $2.  It's madness.

Alter misleads the public (surprised?)

There probably won't be an Act of Congress or a law signed by Obama publicly enacting an immediate single-payer healthcare plan.

If I understand correctly, Obama wants to enact a government-run health insurance system for those who 'can't afford' private health insurance.

Of course, the premiums will be so low that everyone will want to sign up. And since there (intentionally) will be no means-testing, everyone will be allowed to enroll. (Think of this as food stamps for everyone. How fast would food prices rise if government was paying for it?)

This will eventually run every other health insurance provider out of business, ensuring a government monopoly on health care.

And now you have...socialized healthcare!

But this is only the beginning.

In the manner of monopolies everywhere, Obama's new plan will slash doctors' pay, virtually enslaving them, and drug prices, forcing them to slash funding for cancer cure R&D, while rationing care, writing off patents deemed 'not worth the cost of treatment' and dictating lifestyles by threats to deny care.

All the above are documented facts in countries with socialized healthcare.

In one country 25,000 unnecessary cancer deaths have been estimated as a result of rationed care. Canada spends $1 billion annually sending patients to the US for treatment for ailments Canada has neither the expertise nor the equipment to properly treat.

(But there is hope. One of Canada's hospital systems is virtually wait free. It's possible to get a complicated knee operation done within two days! You ask how this is possible in such an inefficient government run system? Simple. It's veterinary carehttp://www.liberty-page.com/issues/healthcare/pets.html)

And for all the real problems with privatized healthcare, they are at least accountable to someone. You can appeal to a higher level, go to another insurer, or even pay for the treatment yourself.

But under a fully-formed socialized healthcare regime, denial of care virtually equals a death sentence. The patient has no recourse. The patient may not pay for his/her own treatment and doctors are not allowed to accept private funds. 

Citizens are totally dependent on the government's judgment regarding funding. If it is underfunded, people die waiting in long lines for rationed and often urgent care.

Apologists like Alter use their talents in every society to deceive the public and  make tyranny acceptable. They are truly contemptible.

NOLI PUGNARE ME OCCIDERE

Excellent post.  The dirty

Excellent post.  The dirty little secret that few seem to ever mention is that medical progress itself has to grind to a screeching halt once the government is rationing it; there's just no way to invest in progress.  

By the way, I "meet" people online all the time who claim to be Canadian or British who claim that their health care is "free" and that all the stuff about the lines, the waiting, the denial of care, the unavailability of care, or even any minor inconvenience, are nothing but myths spun by paranoid Americans.   I believe they are liars, but they sure convince their virtual friends easily enough.   Oddly, they are always leftists...any suggestions for replies to such people?

That's A Lot Of Dinero

I feel for you, brother.  This kind of crap causes good physicians to retire or leave small towns. 

(the rest of this post is cynical)

How much of your losses were you able to deduct on your taxes?  I'm boldly guessing $0.00.

Since you're the only doc in town, having market share, you do have some juice in contracting with the InsuCos?  Not much?  Yeah, typical InsurCo anti-anti-trust tactics.

At least I hope you get the extra few percent from Medicare since you are rural, which helps until they cut reimbursement another 5-10 percent next year.

Ain't the business of medicine grand!

 

Spin it baby

Oval office, Barkey and his highest level cabinet have a meeting.

Barkey: Okay, were having some perception issues with the Health Care thingie, who's in rotation today?

Axelrod: Uh, er, uh, uh, uh, duh, I think it's Alter.

Barkey: Good. What network?

Axlerod: Uh, er, uh, uh, uh, duh, MSNBC.

Barkey: Good. Larry, did you send them the check?

Summers: You betcha! The biggest one yet.

Barkey: Did you get him the script for the teleprompter?

Axlerod: Uh, er, uh, uh, uh, duh, yeah but he says he doesn't need a teleprompter, that's only for you.

Barkey: Tell him to use the %$#^&^^% teleprompter! That's the only way we know he's on message.

Axlerod: Uh, er, uh, uh, uh, duh, okay.

Barkey: Alright, get the next talking head lined up. I don't think this one's going down easy. Getting the top 2% to pay for everyone is gonna be a tough sell. But I've sold less appealing crap than that before. I know I can do it.

Summers: Uh, boss, I was doing some math and I think we're gonna hafta modify yer little plan some.

Barkey: Whatdoyamean? Modify?

Summers: We, uh, duh, er, it seems as though were gonna hafta tax the top 50% to pay for the other 50%. You, know, the 50% that don't pay any tax and are set to get those welfare, er, rebate checks every year.

Barkey: Crap! You &*&^$#%@# idiot! All I had to sell before was a high mileage Cordova, now I've got to sell a rusted out Gremlin. Do you have any idea how hard it is to sell a rusted out Gremilin? Oh, wait a minute, retract that, I can sell any piece of crap to anyone and make them like it. Sorry, I got caught up there for just a moment. No prob, I'm on it. Who's in rotation for tomorrow? Brooks? I see we've got him back on board. Good work on that, guys. Anybody got a fag? I need to smoke. Doing this kind of s__t is almost as good as sex. I always need a cig right after sex.

Take a look around, and

Take a look around, and you'll get a clear picture of what socialized medicine will look like under Obama.

Like the auto executives and banks, he will force all the top doctors to reduce their salaries to a pre-defined "cap" -- and then claim this will attract top doctors to the field.

Like Joe the Plumber, he will force the top drug manufacturers to "share the wealth" -- by providing their trade secrets or manufacturing capabilities to others so as not to take advantage of breakthrus these top people have discovered -- and then claim that "it really takes a village" to make advances in science.

Like small businesses or anyone working hard and making over $250K/year, he will extract heavy fees and penalties from anyone who "can afford" it to give to anyone with their hands out -- and then claim that this is "only fair"

And then, unlike anything we've ever seen (but is currently going on in Britian), he will set up his commission to determine, on a case-by-case basis, whether individuals "deserve" treatment. And the racist that he is, I guarantee you he will make sure that political leanings, race, age, and sexual orientation will be factors in whether medical attention is denied or granted.

___________________________________ 

The challenge is to follow a consistent plan despite inconsistent prices - Sarah Palin, State of the State of Alaska speech

i hope john boy has another gig lined up

after newsweek goes bye,bye. another once proud publication getting thinner and thinner by the issue. i laugh when my wife's copy arrives in the mail. i almost threw it out. i  thought it was one of those coupon/circular thingies.

Isn't that not special....

We need to stop stigmatizing, the name calling, the socialized medicine, the government-run programs.  All that is just BS.

Ah, the old "the debate is over" tactic.  And I thought labeling something as "BS" was "name calling."

 

Ok. Lets call it something else...

OK. Lets call it something else. I don't want Jonathan Alter's Stinkin' Health Care System just because it's a shining example of his kumbaya world view of social justice. If you want your 86 year old mother or father to get "bumped" for medical treatement by some non-citizen immigrant simply because his or her chances of survival are better, or it's the "right thing to do," take your pipe dream bs somewhere else! Jonathan Alter's allegiance is to the world. The United States of America is still "our" country, even though Jonathan is doing his best to change it.

If the gov't is using our

If the gov't is using our tax dollars to pay for someone else's medicine, then that's "SOCIALIZED MEDICINE".

Must admit

I consider Alter an authority on BS....so....

 

Look's to me like he need's

Look's to me like he need's a can of spray on hair the little freak.

Why are libs so freakin ugly.Geee's everytime I see one it's like the circus is in town.Yea that's right, Im getting personal.

Don't feel bad.  Last night

Don't feel bad.  Last night I showed my son and brother in law this picture:  http://mine.icanhasc... and my son said, "Yeah, he's circus-ugly."  We all had a good laugh about that; the term just cracked me up. 

I also believe...

Isn't Alter a cancer survivor? Does he want those records funneled through the govt or just between his docs and the local hosps? What if care is rationed by banging the national sick people database against some half-baked studies on what works and what doesn't--what if the therapies he enjoyed were deemed "ineffective" by someone? I think the present health system is a travesty--but we need more than a one-week "debate" and those stupid asskissing meetings (thank you for listening to us at last, etc). Alter should be concentrating on that.

jonathan alter

Jessie R. Hamby        Who the hell does he think he is, telling US what we "need" to do? How about the media stop the B.S., and start REPORTING the news! I am sick & tired of these idiots "telling the people what they think we should think & do, & who we should listen to. If I want to call Obama a socialist, I will call him one. If I want to call Alter an idiot, I will call him one.

OK, Jonathan...we'll stop

OK, Jonathan...we'll stop calling it "socialized medicine" and start calling it what it really is:

Fascism.

Is that better?

Rational Liberty: Where Reason and Government Collide - The best website ever!

Thank you!

Thank you!

"Newsweek's Jonathan Alter:

"Newsweek's Jonathan Alter: Conservatives Need to Stop the 'BS' of Calling Obama's Plan 'Socialized Medicine"

Proving:

A: It's true

B: It's effective

C: The libs know it is. 

The "Mainstream" Media: By liberals. For liberals.

WORDS MATTER...

 Hey Norman,

You are dead on. I does'nt matter who is bitching about the SOCIALIST label, today's leftist does'nt like what they are doing being labeled SOCIALISM.

Joe "The Plumber" pointed out to Obama that his economic & tax policies as sounding like SOCIALISM, & the MSM machine went after him hell bent for leather. His privacy was violated by Ohio state officials. When the NYSlimes asked Obama about SOCIALISM during an interview, & he calls them back afterword to clear the air about it. Now Jonathan Alter is bitching about it, & it is clearly pissing off these hard left SOCIALISTS that people are calling them what they are...SOCIALISTS.

The fact is this, the MSM, the Dems, & the Obama administration HAAAAAAATE the fact that many Americans are catching to the fact that Obama is a SOCIALIST, & THAT what he is doing is SOCIALISM. If Jonathan Alter does'nt like, too damn bad.

 

 "The Fairness Doctrine = Jim Crow laws for Conservatives".  Jim Quinn from "Quinn & Rose"

Liberals like Alter need to

Liberals like Alter need to stop the BS...period.

Health care/insurance is

Health care/insurance is already rife with a typical non-working combination of government regulations and capitalist price-fixing.

Allowing insurance companies to compete will drive down costs.  Taking over the health care industry by the government will only cost way more...for those who actually pay taxes that is.

One of the 34% who thinks George W. Bush was a great President. One of the 61% who wants to bring back the stock and pillory (yep...approval for Congress now at 39%...do you believe that!?).

What a complete blithering

What a complete blithering idiot this man is, he always has been...he has just been through chemo/cancer BS...he is lucky he has had the coverage and choices he has had to be alive...because if the govt. takes over, people like him, millions of us all out here, would most likely be dead with what they have planned....but then again...that's part of the plan...in my opinion.

Leftists like him are such blind, partisan hypocrites.

Do as I say...not as I do.

They are bringing us Orwell's 1984...

when they change the meaning of words to mean just the opposite.  In the Liberal's "Brave New World", government run medicine are just their words for "Privatized Medicine".  I have a question.  Is there anyone out there in "NewsBusterLand" who actually subscribes to this nitwit's magazine?  Jim Webster

Obama/Democrats buried

Obama/Democrats buried their health care plans deep within the stimulus bill.  They did not bring it up for debate, just sneeked it in the 11 thousand page stimulus. Next, they rushed it to get it passed, even though lawmakers did not read it. 

Why did they do that?  What are they hiding???

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. (via bloombergnews.com)

Sshhhh. No one tell Newsweak's Johnathan Alter, but obama's healthcare plan sounds like socialism to me!

TN Mom: While the Dems

TN Mom:

While the Dems buried the healthcare reform passages among all the other passages in a 1000 plus page document voted on with less than 24 hours time to review and debate, the legislative changes/additions to government provided healthcare (Medicare/Medicaid) were known but ignored by our legislators.  For instance, Bloomberg News published a commentary on these healthcare changes on Feb. 9th, four days before the vote.  Frightening!

Medical insurers, private as well as government-based, have used several criteria on what constitutes acceptable healthcare for some time - safety, effectiveness, and cost.  For instance, insurers have a Formulary of medications, a list of approved drugs that are covered under the insurer's plan.  Medicaid is the most stringent - prescribe a drug not on Medicaid's formulary and the pharmacist will call for clarification/reselection, otherwise the patient, usually cash strapped, will have to pay out of pocket.  The idea is that the government has determined their are similar drugs that perform essentially the same and that using generics, for instance, save money.  A patient may be granted an exception IF need is demonstrated by their physician. 

The savings to the government are signifigant, the patient receives a medicine that is effective (though may not be optimal in some respect) and the physician and pharmacist have an additional layer of bureaucracy to slow down their day and add cost at some point in time to implement and follow the government's dictates. 

The intrusion of the government into the patient-physician relationship is tolerated because the patient is usually helped at a reasonable cost and the physician acquieces to decreased autonomy because it is of small proportion, they do not want to hurt the patient with out of pocket expenses, and they want to be reimbursed and avoid auditing.

The impact of these potential sea changes in the practice of medicine, by force I might add, represent a furthering of the death of American healthcare as we know it by a thousand cuts.  And this particular cut is a deep one.

These new regulations are meant to significantly and imperiously change the practice of Medicine.  Good luck appealing your case to the "Federal Council".  If the authoratative bodies in Canada and England are any indication, and they were templates for this legislation, then the American people will have little recourse before a reversible or manageable condition becomes permanently debilitative or results in death.  Quality Of Life, a consideration in current therapies, may no longer be a consideration if the government decides the cost is not consistent with the public's interest -

If you're old or have a rare condition, live with it or do your country a favor and die before you cost the rest of us too much.

And what inducement is there for research and development into new treatments if the government disallows spending for diseaeses/conditions it has deemed unworthy of treating currently?

Yes, this is change.  Just not so much the Hope as promised.

Against racial preferences,

Against racial preferences, diversity goals, etc, in hiring?  People like that are racists.

Against illegal immigration?  People like that are racists.

Saying the banks are being nationalized?  That's BS.

Saying Obama is promoting Socialism?  That's BS.

Calling government run healthcare socialize medicine?  That's BS.

Against tax cuts for people paying no taxes?  You don't care about people in need.

etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc.

 

Socialized Medicine

You know the old saying, "if it looks like a duck, walks like a duck, quacks like a duck, its a duck." Same thing with socialized medicine. I guess to be more accurate we could call it Marxist medicine or Stalinist medicine, both apply and are accurate. Change we can believe in, you betcha'.

http://www.classictv...