29 September 2009

A fun quote about tort reform for healthcare

From DNC chairman Howard Dean, speaking at a town-hall event in late August:
Asked by an audience member why the legislation does nothing to cap medical malpractice class-action lawsuits against doctors and medical institutions (aka "Tort reform"), Dean responded by saying: “The reason tort reform is not in the [health care] bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on. And that’s the plain and simple truth.”

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28 September 2009

Choosing not to fight the "War of Necessity"

Obama said it hundreds of times on the campaign trail: Iraq was Bush's "war of choice" that distracted him from the "war of necessity" in Afghanistan. There was the promise that the United States would focus on this neglected but essential front in the war on terror, or whatever the Obama administration is calling it these days. And on this point, I have agreed wholeheartedly with the public pronouncements of the President--the war in Afghanistan is too important to risk losing.

Well, there's some sense now that Obama has not paid a terrible amount of attention to the job of defeating the Taliban. In a televised interview, General Stanley McChrystal has admitted that he's only spoken to the President once since taking command of the theater more than two months back.
“I’ve talked to the president, since I’ve been here, once on a VTC [video teleconferece],” General Stanley McChrystal told CBS reporter David Martin in a television interview that aired Sunday.

“You’ve talked to him once in 70 days?” Mr. Martin followed up.

“That is correct,” the general replied.

Sure, you can argue that the President has had a lot on his plate. But ask yourself: how important can Afghanistan be to Obama if he's putting a higher priority on personally petitioning the IOC to award the Olympics to Chicago?

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As far as I'm concerned, Roman Polanski can rot in hell.

Not normally the stuff I'd blog about, but a passage from this CNN report has me agape:
"He's a brilliant guy, and he made a little mistake 32 years ago. What a shame for Switzerland," said photographer Otto Weisser, a friend of Polanski.
A little mistake...the same article has the following description of what happened:
Polanski was accused of plying the [13-year old] girl, Samantha Geimer, with champagne and a sliver of a Quaalude tablet and performing various sex acts, including intercourse, with her during a photo shoot at actor Jack Nicholson's house. He was 43 at the time.
These facts are not in dispute, nor is the fact that Polanski fled the country when it became clear he might have to serve real jail time for his "little mistake."

Brilliance, whatever that might mean, is no defense against child rape. Isn't that something we can all agree on?

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25 September 2009

Friday Melange

So it's Friday afternoon, and I'm sitting outside being caressed by a cool, early autumn breeze. I've also got a lot of other work to get through, and a variety of tabs are clogging up my Firefox window. But for the sake of the archive, let's run through them fairly quickly.

  • There's a video making the rounds that shows a bunch of elementary-school students practicing a song praising "Barack Hussein Obama." The lyrics are pretty...well, they're just not right. I find it interesting that the superintendent of the school district excuses it by saying, "The recording and distribution of the class activity were unauthorized." OK, all better now.
  • Yesterday there was a hubbub about the various world leaders attending the UN conference. Apparently, Britain's Gordon Brown repeatedly sought a few minutes with Obama, but was snubbed no fewer than five times. My reaction at the time was, sure, I bet Gordon wants a photo-op with Obama to help his sagging poll numbers, but at the absolute minimum his country has 9,000 troops in Afghanistan, where we're struggling. In short, cut the guy some slack and give him his face-time.
  • Then of course we learn that Iran has been secretly building a hitherto unknown uranium-enrichment facility, and all of the sudden the US, UK, and France are putting up a united front at the G20 summit in Pittsburgh. Maybe those five minutes the day before would have been a good investment.

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23 September 2009

A little extra confirmation is always a good thing.

Seems like CBO Director Douglas Elmendorf has struck again:
Congress' chief budget officer is contradicting President Barack Obama's oft-stated claim that seniors wouldn't see their Medicare benefits cut under a health care overhaul.

The head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, told senators Tuesday that seniors in Medicare's managed care plans would see reduced benefits under a bill in the Finance Committee.

The bill would cut payments to the Medicare Advantage plans by more than $100 billion over 10 years.

Elmendorf said the changes would reduce the extra benefits that would be made available to beneficiaries.

Please remember what the President told the AMA on 15 June: "If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan."

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22 September 2009

Baucus, Humana, Maddow

The story so far:

1) Earlier this year, President Obama proposed eliminating Medicare Advantage, a program by which seniors can receive their healthcare through private plans, rather than directly through Medicare. Current stats show that approximately nine million are enrolled. On the 12 January 2009 edition of This Week with George Stephanopolous, he said
"We’ve got to eliminate programs that don’t work, and I’ll give you an example in the health care area. We are spending a lot of money subsidizing the insurance companies around something called Medicare Advantage, a program that gives them subsidies to accept Medicare recipients but doesn’t necessarily make people on Medicare healthier. And if we eliminate that and other programs, we can potentially save $200 billion out of the health care system that we’re currently spending, and take that money and use it in ways that are actually going to make people healthier and improve quality."
Please remember what the President told the AMA on 15 June: "If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan."

2) Humana, a large insurer, sent out a letter to its Medicare Advantage participants stating, in part, that "millions of seniors and disabled individuals could lose many of the important benefits and services that make Medicare Advantage health plans so valuable."

3) Senator Max Baucus referred the matter to Health and Human Services, which then penned a cease-and-desist letter to Humana. In the wake of this, the Humana story has been all over the news.

I tend to agree with the Wall Street Journal on this one when they represent Baucus's actions as bullying.
[Baucus stated that] "The health-care reform bill we released last week strengthens Medicare and does not cut benefits covered under the Medicare program—and seniors need to know that."

In fact, the Baucus draft legislation slashes $123 billion over the next decade from Medicare Advantage, which Democrats hate despite the fact that almost one-fourth of beneficiaries have chosen it over traditional fee-for-service Medicare. One reason seniors like it is because private insurers focus on quality and preventive care and try to manage benefits, as opposed to simply paying bills.

A new study from America's Health Insurance Plans, the industry trade group, finds that seniors on Advantage in California spent 30% fewer days in hospitals over fee-for-service patients, based on federal data. Democrats say that insurers are "overpaid," but the cuts—as Humana correctly noted—mean that seniors may lose this coverage.

In short, both Obama and Baucus have proposed either eliminating or slashing Medicare Advantage...and they're complaining when the insurance industry rightly warns their customers that their current plan may be on the chopping block?

A quick note on the "Maddow" point: I first heard of this kerfuffle while flipping past the Rachel Maddow show. It is my recollection that she introduced the topic by quoting from the Humana letter, but in a choppy way that disguised the fact that they were talking specifically about Medicare Advantage. While I have not been able to confirm this (I haven't been able to find a transcript of the program), it would not surprise me.

You can bash greedy insurers all you want; but it seems to me that you shouldn't give them too much grief for telling the truth.

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18 September 2009

Something that's been bothering me...

The more I consider Obama's healthcare proposals, the more I keep coming back to the aspect of constitutionality--which, I realize, is a perilous thing for a non-lawyer to do. Nevertheless, there appears to be a fundamental disconnect between a) asserting that the interstate commerce clause gives the federal government the ability to mess with the health-insurance marketplace, and b) the fact that health insurance companies can't currently operate across state lines.

An editorial in today's WSJ, however, raises another interesting point: whether sticking the uninsured with a penalty "excise tax" is a form of punitive taxation:

Taxation can favor one industry or course of action over another, but a "tax" that falls exclusively on anyone who is uninsured is a penalty beyond Congress's authority. If the rule were otherwise, Congress could evade all constitutional limits by "taxing" anyone who doesn't follow an order of any kind—whether to obtain health-care insurance, or to join a health club, or exercise regularly, or even eat your vegetables...a tax that is so clearly a penalty for failing to comply with requirements otherwise beyond Congress's constitutional power will present the question whether there are any limits on Congress's power to regulate individual Americans.

One further question: if the Obama reforms aren't scheduled to go into effect until 2013, how will the inevitable legal challenges impact their rollout? Politically, I wonder whether it would be better for Obama to get a reform bill passed sooner, so that lawsuits can be characterized as obstructionism for the 2012 campaign

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