Extremist Folly of the Week #2: Healthcare Squabbles
Looking for proof that the U.S. desperately needs to put a third (i.e., moderate) party in power? Look no further than the maddening trench warfare in Congress over healthcare reform.
Republicans are clinging stubbornly to the “if it ain’t broke, don’t fix it” school of reasoning, which conveniently omits the inconvenient truth that contemporary healthcare is entirely unaffordable for anyone without insurance… and nearly as unaffordable for anyone who has to PAY for insurance.
Meanwhile, the Obamacrats have been promoting the creation of a totally overhauled, top-heavy, government-run medical establishment: a grotesque exercise in excess that would gum up the vital pipeline of medical care and impose unacceptable restrictions on our choice of physicians and treatments. Naturally, their proposals are accompanied by billowing clouds of paper (1000-plus pages of mostly indecipherable verbiage that few lawmakers have actually read) and a general haziness of focus probably designed to conceal the socialistic nature of their grand plan.
The New Moderate feels obligated to ask why nobody on either side of the aisle has proposed a simple, federally-subsidized health INSURANCE program for people who aren’t already covered by their companies. Well, I guess I just answered my own question: it would be too simple. Imagine: no vast government-run medical bureaucracy… no disastrous medical expenses for anyone foolish enough to get seriously ill. Just a simple extension of medical insurance at a nominal cost to everyone who needs it. End of story… if the moderates were in charge.
THE NEW MODERATE 
Ok, this is absolutely my biggest problem with Obama. He is the President – he has had the opportunity, dare I say the obligation, to frame and communicate the debate…his job is to lead us in finding a way to reform a system that desperately needs reform…..our freaking HEALTHCARE system, for heaven’s sake, the institutions that protect what is most precious to every American.
And what has he done? Allowed the reform process to be controlled by the left wing leadership of congress, demagogued the hell out of the process, refused to call for hearings on the bill (so how would we even know what the “other side” thinks?), made false accusations about opponents of the bill, etc. etc….
In short, shown no leadership on this issue, which he himself calls the most important of his presidency, at all.
So now we’ve got all the loonies, from both sides, screaming at the top of their lungs, legitimate and concerned opponents of the plan not able to voice their opinions without fear of ending up on some White House “enemies list”, and the very obvious moderate, sober and cost effective solutions (tort reform, possible expansion and /or reform of medicaid, etc) not even being talked about at all.
So, I think the answer to your question about why no one has proposed a moderate solution is that they probably have, but they have basically been shouted down. A real shame.
Ah yes, at times like this I wonder about the effectiveness of representative democracy. At least a king with absolute powers would be able to get something passed. He’d simply decree healthcare reforms, and his word would be law.
Well, maybe the two-party system is at fault. If there were a moderate party in power, we wouldn’t have so much back and forth, he-said/she-said squabbling.
You brought up the issue of tort reform, which I think is crucial (and I didn’t mention it in my post). I know some columnists like Charles Krauthammer have urged action on this front, but I have no idea if Congress is taking any steps. If we could cut down on medical lawsuits, doctors wouldn’t have to pay $100,000-plus annually in malpractice insurance (which is an outrage at this point). They also wouldn’t have to prescribe costly tests for every ache and pain out of fear that some irate patient will sue them. Both factors would cut medical expenses substantially, and all our premiums would come down as well. In an ideal world, anyway.
Working in the healthcare industry, I’m thoroughly convinced that much of our outrageous medical costs are directly related to bureaucracy. Our “healthcare industry” is HUGE. The people at the bottom (or the people actually working with the patients) are directing the care. But the rules/ regulations are being set by committee at the top, people who have never touched a patient. The job of these “committee people” is to attend meetings and make rules for the millions of people at the bottom to follow. Have you ever even tried to get even 3 people to do something you want them to? Now try to get millions to do the same.
So how do you get millions to “behave” and do what you think they should? Produce time-sucking paperwork. Then create committees to review the aforementioned paperwork. Then write rules that fine and punish those who don’t comply to your rules.
Case in point: JCAHO(Joint Commission On Accreditation of Healthcare Organizations), of which, every single hospital in America is terrified, because without their seal of approval you don’t get Medicare funding, decided last year that physicians were not doing enough to teach their patients about the dangers of cigarette smoking. So they made it a national goal to improve this statistic. A worthy goal yes.
But, as a doc, how do you prove that you have told your patient that smoking is bad, and then relate this info to a giant bureaucracy like JCAHO? Paperwork. And lots of it. Not only is there the cost of the individual healthcare organization to rewrite and revamp ALL their current physician orders, progress notes, policy, consultation reports etc to reflect this new rule, but there is the time of the workers to actually follow though with all this bullshit.
It is no longer enough for the physician or nurse to say somewhere in their charting, “discussed the bad effects of cigarette smoking with the patient”, because this would not comply with JCAHO regulations. JCAHO would not spend the time to actually review an entire patient’s chart. That would be ridiculous, seeing as how the chart in now a giant monstrosity (that no one can find what they need) precisely because of JCAHO regulations.
Multiply the above scenario by hundreds of regulations.
I, as a nurse spend ~1 hour per admission filling out paperwork to comply with JCAHO rules. The doc probably spends more time. Let’s just stick with me for the moment. I make 35$ hour, I admit ~10 patients a week. So $35/ hour X 10 hours/week X 52 weeks = $18,200 a year that my hospital pays me to comply with government regulation/ paperwork. Multiply that number times all the nurses in the US. Or all the admissions in the US. We are talking billions. That number does not include the physician’s time, nor does it include all the ancillary staff etc.
This is what I think: JCAHO needs to do a study on the amount of waste produced by their regulations, and add that to the need committee meeting agenda.
It scares me to death that a bunch of partisan bureaucrats, people who have never touched a patient are writing 1,000 page documents with laws designed to revamp healthcare.
Hallie: Good to hear from a healthcare “insider.” I knew you guys had to deal with a mountain of paperwork, but I had never heard of JCAHO or their absurd requirements. They really have you jumping through hoops, and at great expense (as you noted).
Imagine how much $$ the system would save if we could cut down the paperwork AND implement tort reform to abolish frivolous and excessive malpractice lawsuits.
Is not just Republicans that call the Health Care Law, Obama-care. While Bill Clinton was in office Hillary tried to have a naitanolized Health Care system, it was nicknamed Hillary-care. this Obama-care nickname is just the same continuation of the same idea.When Social Security was created it had a nickname. Anytime a politician purposes a law they run the risk of it being oh wait the laws are always named after those that pose it.