The Rangel Rope-A-Dope
by Big Dog on Jun 14, 2009 at 15:45 Political
Charlie Rangel and his Democrat buddies are working on the Obama health care plan. The plan is supposed to provide health care coverage (we all have access) to those who have no health insurance. The actual number of people who have no health insurance is about a quarter of what politicians report because their numbers include people who have access but choose not to have it, are not entitled (illegals), and those who were without for a short period of time (like in between jobs and elected not to take the COBRA extension). The numbers also include those who are eligible for already available assistance but, for whatever reason, have not signed up.
The Democrats want to rush this trough like they did the bogus stimulus package so that people do not have time to react. They want to have this in place quickly before people find out what it costs and what it involves. Democrats will use sleight of hand and trickery to gain acceptance. They will display a grandiose health plan and talk about all the bells and whistles and how wonderful it will be but they will not talk about how it will be paid for. Sure, they will claim it saves money or that we can afford it by taxing the rich or other such nonsense but they will not discuss specifics. Charlie Rangel wants to make people feel real good about it all before he hammers them with the specifics. He must believe that once people are thrilled they will be less likely to oppose any method to pay for it. The only ones who will not oppose are the ones who won’t pay for it anyway.
In other words, they will not be discussing the $600 BILLION in tax increases required to pay for this monster. We cannot get that much money by taxing the rich so taxes will involve a lot of other folks. First they will consider taxing the health benefits that employers provide. Then they will continue to add taxes until they have forced everyone into government care or until the plan has grown into a monster like Medicare which is more expensive than private run insurance (the 2-3% operating costs are lies) and is less efficient. Rangel said he wants to butter people up before hitting them with the tax bill:
Rangel said that while House Democrats will likely release more details about health policy changes in their legislation next week, the package of offsetting tax increases and spending cuts likely will come later. Democrats, he said, want to put forth the more-positive aspects of an overhaul first. Rangel also wants to let lawmakers have time to study and weigh in on proposed offsets.
“We have a problem in not wanting to attract enough negative attention to the bill in terms of the pay-fors,” he said. “Let them get a good feel for the coverage.” Bloomberg
They have a problem in not wanting to attract enough negative attention to the bill in terms of the pay-fors. That means he does not want to put emphasis on how it will be paid for because it will garner negative attention, as it should. Rangel and his buddies, as indicated above, will roll out the plan without specifics regarding costs and then, later, hit us with the particulars on the cost.
They can’t let a crisis go to waste by telling us the truth because we might get negative.
The government does not belong in health care. It cannot run anything efficiently and it cannot run anything effectively. Everything government touches becomes bloated and suffers cost overruns.
Obama wants this rushed through. He and the Democrats are rushing head first into this with little regard to the consequences. They are going for this without long and proper debates reagrding the pros and cons of any government devised system. They are forcing their will on us.
Will it take a revolution before these people understand that they work for us? Will it take a revolution before they understand that we want smaller, limited government?
Anyone who does not pay taxes and ends up getting free health care (paid for by the tax payers) should have to work every weekend cleaning streets, picking up trash, cutting grass and cleaning graffiti.
When I was a kid my dad would make me get a certain kind of haircut. He said if he was paying for it he got to decide on the style. Those of us paying for other’s health care should have a say in just what care they get.
But remember, you will hear a lot about how wonderful it will be but you won’t hear much about cost. Rangel and the rest of the tax cheats will screw us with that later on.
Related:
Hospitals not happy with part of the plan
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Tags: cost, health care, rangel, tax increases, trickery
BigD: “the actual number of people who have no health insurance is about…”
DAR
Your examples don’t hold up, but it hardly matters since we are paying for their emergency last minute care anyway (in a perverse, stupid and expensive way).
Bigd: “Medicare which is more expensive than private run insurance (the 2-3% operating costs are lies) and is less efficient.”>>
DAR
I read your article. It doesn’t even address the efficiency of Medicare’s delivery of service. Medicare is expensive in the sense that there are a lot of old people and feeding our over priced medical system costs a lot. Plus drug companies spending twice as much on advertising for drugs as they do on research for drugs, is another idiotic freemarket profit driven waste. To quote the author I refer to below:
“The high cost of drugs and devices is a major reason why our hospital bills are so high—drugs and devices account for 15% of the $2 trillion-plus that we spend on healthcare each year.”
Medicare’s efficient delivery of service is unquestionably far cheaper than private for profit systems. It’s not even close and this is for really *really* obvious reasons.
I have already shown you how Canada can keep overhead down to 16.7% while the US’s for profit system wastes 31% on bureaucracy. One health insurer is cheaper than having 1,300? Big surprise eh?
Here a few more reasons from the (general surgeon) author of:
“Money-Driven Medicine: The Real Reason Health Care Costs So Much.”
She takes the claim that a “3% operating cost for medicare is a myth” head on and roasts it to a crisp. And then she roasts the people who comment in her thread too (including the author of the article she was responding to). Read it all here:
Why Medicare is More Efficient Than Private Insurers By Maggie Mahar
Some excerpts:
***
“In contrast to private insurers Medicare doesn’t have to spend millions on marketing, advertising, and Washington lobbyists. On top of that, private insurers must generate profits for their shareholders. In 2003, the HMO industry as a whole reported total earnings of $5.5 billion—up 83 percent from $3 million in 2002…”
…
“But it’s not just the cost of marketing, advertising, lobbying and providing profits for investors that makes a private insurer’s overhead so much higher. Insurers also have higher administrative costs because they are constantly enrolling and disenrolling customers as people change plans. (The average turnover in an employer-sponsored insurance plan is 20% to 25% a year. By contrast, Medicare patients stay put. Even if they could switch, most prefer Medicare’s coverage to the coverage they had under a private insurer.)” (ibid)
DAR
If you want to talk about the VA, it is another example of government efficiency kicking the behind of the money hungry greed/profit system. Note:
“The fact is that the government-run U.S. Veterans healthcare system is now considered signficantly more efficient than private-sector healthcare according to The New England Journal of Medicine (“Effect of the Transformation of the Veterans Affaris Health Care System on the Quality of Care, May 29, 2003)The Annals of Internal Medicine (“Diabetes Care Quality in the Veterans Affairs Health Care System and
Commercial Managed Care: The TRIAD Study,” August 17, 2004) U.S. News & World Report (America’s Best Hospitals, Military Might, July 18 2005); the American Journal of Managed Care (“The Veterans Health Administration: Quality, Value, Accountability, and Information as Transforming Strategies for Patient-Centered Care,” 2004,10; part2); Washington Monthly (“The Best Care Anywhere,” January/February 2005)and The Washington Post (“Revamped Veterans Health CAre Now a Model,” August 22, 2005).
Link
DAR
So your claim: “It [government] cannot run anything efficiently and it cannot run anything effectively.”
Is once again, roasted.
D.
——————-
“The total costs to administer claims for Canada’s public system eats up about 1% of all health care expenditures. In the US, Medicare claims administration costs take about 2-2.5% (US pays on a per hospital stay basis rather than lump sum budgeting as in Canada.) Total administrative costs in Canada including hospital administration and physician’s office costs is about 14% of total spending, as compared to about 25% in the US. Some US insurance costs can devour nearly 1/3 of the dollars spend on health care.”
–Karen S. Palmer MPH, MS, California Physicians Alliance (CaPA), San Francisco, January 13, 1999. Link
Sorry, Medicare is not efficient. Those of us who have had to deal with it know better. Also, administrative costs are not added in because the government absorbs them.
The costs are high and the delivery of care is not overly efficient. The people who study these things have shown the hidden costs and those costs do not include what it costs each time all the Congress deals with an issue. Add all the salaries of Congress and staff for when they work on Medicare issues.
The red tape involved is a nightmare and it is so wonderful people have to buy supplemental insurance to make it.
As for the ER, we have laws allowing doctors to turn people away from ERs if they are non emergent. The only requirement is that the patient be evaluated to see if they are an emergency. If doctors would send the non emergency cases away then the problem would not exist.
I also know people who go to the ER because it takes a week or two to get a doctor appointment.
People have access to a doctor. Just call and get an appointment. You have to pay your own bill but you can see a doctor. There are also free clinics.
I already linked to the stuff about Canada. It is not a good system and it does not run as efficiently as you say. Too many people up there complain and the issues with cost escalations are real. You keep touting it but it is not good. Government should not run business or our lives. If you want government providing your health care you are a slave, not a free man.
Beyond a few mere assertions, this does not respond to a single point made in my comment. So, completely non-responsive.
D.
————–
“When I was in graduate school in Hawaii, Governor Michael Dukakis taught a health policy course. We didn’t agree on things like employer mandates, but we had fun arguing about it. At the end of the course, he decided that he wanted to visit Canada, and so we went to Vancouver to talk with Robert Evans (a brilliant health economist) and others. We visited a large metropolitan hospital and the governor asked to see the “billing wing”. We took him to a small room about the size of my kitchen and pointed to the small staff who made up this “billing wing”. The Governor was amused.”
— http://www.thirdworldtraveler.com/Health/O_Canada_KP.html
I should let you talk to my brother about the VA he has been through the grinder and can tell you just how bad it really is, and it is bad. Next time D, you should stick to the myriad things you allegedly know about, and possibly read some things that don’t lean left.
The VA seems great unless you are a patient, then your view changes, but isn’t the patient’s view all that is supposed to count?
I just had an in depth conversation with a gentleman yesterday who had nothing but glowing wonderful things to say about his VA medical care. He couldn’t say enough good things. Likewise I have wonderful things to report about my experiences in the Canadian health care system. There are stories on all sides.
True Tamara, even a blind pig finds an acorn every once in awhile- I’m just saying my brother has had a bad time for getting his liver cancer 1- tested, and 2- treated.
Government has protocols that have nothing to do with medicine, and everything to do with government, and that is not a good thing.
Darrel- if medicare and medicaid are so efficient, how did Hussein find so much money to carve out of them- about 300 billion so far- could it be that they were— wait for it—wasteful?
I think so.
Medicare is inherently wasteful. The article I linked to shows that. It costs way more than anticipated and the administrative costs are hidden in the government so they can make bogus claims about 2-3%.
D, I love how your Canadian butt is an expert in everything American. You site articles from 2004-2005 for your VA references. Why not actually follow BigDog to work and ask how many of the people in the ER are using the VA system for health care. Ask them what they think about it.
When I was lived at home with my father, he paid extra to have health care for my brothers and I. If something was wrong, we could make a same day appt with our doctor, who knew our names, birthdays, and brief medical history every time we went in. I had hives, the doc gave me a whole bunch of stuff to take care of it and it was gone in just a couple days. My brother sliced open his finger when my parents were on vacation (leaving me to drive him to the doc). I didn’t even call, just drove him in to the clinic and he was taken care of on the spot. My other brother needed to have one of his testies dropped surgically when he was 4, they discovered and 3 days later it was fixed.
Fastforward to the last 10 years and my life with the military and VA health care system. My son is diagnosed with a condition that requires meds daily. Since it is psychological, the psychologist referred us to the psychiatrist. It took 2 weeks to see him to get the meds. My husband breaks out (downrange) and doesn’t get seen until he gets home a month and a half later. Turns out, he had a bad case of hives. They give him Claritan and some hydrocortizone cream, tell him to come back in a week, and I end up driving him to the ER two days later because he can’t open one eye and can barely breathe, the ER gives him a shot in the butt and he’s cleared up the next afternoon. And had the VA diagnosed my grandfather a year ago with cancer, he’d have more than 8 months to live. My best friend had a brush with thyroid cancer as a teen, she has to take meds to keep it in check. As soon as she married a military member and was under the VA system, they made her retest for everything. It took them 2 months to get her the meds she needed. She was paying for them out of pocket for that time. Her son has terrible food allergies and she needs to carry an epi pen in her purse. She needed to use it one night and requested to have the dr put in a perscription for a new one. He wanted to see the boy first. Took a week and a half before she could get in to see the dr. That was the worst week and a half I’ve seen. She would not let him eat anything that she did not inspect with a fine tooth comb.
You can call these anecdotes all you want, but it’s the way military and VA health care is run. The doctors are overbooked, don’t care and are in a rush to punch out as many patients as possible so they can say they met their goals. Remember Walter Reed? That’s what every hospital is going to look like because no one will be paying for more than cosmetic fixes. Once we have gov’t health care, you’ll learn how great the VA system is because it is gov’t run. Maybe you’ll go back to Canada, don’tchaknow…
aMUM: D, I love how your Canadian butt is an expert in everything American.>>
DAR
Having lived in Canada 21 years, and in the US 22 years, my butt does have some first hand experience of both countries. And I’m a half-breed. One cheek is American, the other Canadian, so to speak.
AMUM: You site articles from 2004-2005 for your VA references.>>
DAR
Four years is certainly fresh data for such things.
aMUM: Why not actually follow BigDog to work and ask how many of the people in the ER are using the VA system for health care.>>
DAR
Because that would be anecdotal, practically useless, and impractical (I have my goats to tend).
If you read the link I provided, the learned surgeon actually explains what has been going on at the VA over the last few decades. And she backs it up extensively. It was vastly improved in the 90’s and participation went up considerably. This increased costs and Bush underfunded it. Republicans like to talk about supporting the military but, as your Walter Reed example shows (and McCain’s rating of 20%, versus Obama’s rating of 80% from DAV shows), sometimes they are weak on the follow through.
The claim that government run health systems (medicare, VA) are “more expensive than private run insurance” and are “less efficient” (BigD’s words) are not just false, they are *absolutely and utterly absurd*, not even close, and clearly refuted by the material I have posted and BigD has ignored (because he can’t rebut it). He destroys his credibility with such silliness. Standard stats on this, as I have provided over and over from multiple sources, show the inefficiencies and bloated overhead costs may be as much as 10x higher in private insurance (3% v. 30%), and for the reasons I have shown.
He can try to play with those numbers a bit, but he is starting at a near ten fold difference.
BigD can’t accept these facts because it contradicts his dogmatic ideological devotion to a freemarket religion he has spent a lifetime nurturing a belief in.
Thanks for sharing your anecdotes but they don’t address the matter in question.
D.
———————
ps. Incidentally, we see similar rates of efficiency when we look at the low cost of government managing social insurance programs in this country and others. When they privatize, the costs go up, way up, and for obvious, simple to understand, reasons.
Your “learned surgeon” is a registered dietician at the Lahey Clinic, with a Master’s in Public Health and a Master’s in Science. Some surgeon… I read with my eyes and my IE scanner 4 times and never found a mention of VA, miitary, or veterans healthcare. Please cut and paste (since we know you are a pro at that) the parts where she explains what has been going on with VA/military health care. Maybe all the drs I’ve seen over the last 10 years have just been having a bad day…
Walter Reed was on the chopping block for the military down-sizing. It wasn’t recieving money even though more wounded warriors went there than any other stateside hospital (makes a lot of sense to close the hospital that is the most essential). In the military, you learn that if you need money, you have to show the need for money. Saying, “I have to repair A, B, and C” gets you nothing more than a “Work with what you have” from the people holding the purse strings. But when said military officials let it slip to the public that a hospital is moldy and falling apart, public uproar gets the said strings loosened.
If I were allowed (certain “unalienable rights” are not available to military members and their families), I would hold a poll of my own to show you all what the real opinion of VA health care by those receiving it. The military health care system will be used as the model for govt health care if/when it goes that far.
Incidentally, the costs you mention that are lower; are those the costs to the patient, the govt, or the taxpayers? How do you suggest we make sure no illegals get the health care that the taxpayers are paying for? What about the people who don’t pay taxes? Is it fair to the taxpayers to have to pay for the housing, food, and health care for the unemployed and lazy?
Mother- you should probably ignore Darrel, his goats think he’s great, and he’s gotten a big head from all their praise-the truth is that free market medicine is the only way that we will be able to beat cancer and other diseases, because the government would squash innovation and limit the amount of money necessary for research, so we would be stuck with old medicines for new diseases, and forced to take a number, because who would want to be a doctor? Under government conditions? Would the government force people to become doctors?
aMUM: “I read with my eyes and my IE scanner 4 times and never found a mention of VA, miitary”
DAR
Read the comment section. As usual, that’s where the action is.
aMUM: How do you suggest we make sure no illegals get the health care that the taxpayers are paying for?>>
DAR
I don’t know. Control costs and it becomes much less of a problem.
aMUM: What about the people who don’t pay taxes?
DAR
Everyone pays taxes.
Gotta go.
D.
aMOM: The military health care system will be used as the model for govt health care if/when it goes that far.>>
DAR
This fellow thinks that’s good and wrote a book about it.
***
Best Care Anywhere: Why VA Health Care is Better Than Yours (Paperback)
Editorial Reviews
“The long-maligned Veterans Health Administration has become the highest-quality healthcare provider in the United States. This encouraging change not only has benefited veterans but also provides a blueprint for salvaging America’s own deeply troubled healthcare system. “Best Care Anywhere” shows how a government bureaucracy, working with little notice, is setting the standard for best practices and cost reduction while the private sector is lagging in both areas. Author Phillip Longman challenges conventional wisdom by explaining exactly how market forces work to lower quality and raise prices in the healthcare sector, and how U.S. medical practices have a weak basis in science. The book, expanded from a widely praised article in the “Washington Monthly,” mixes hard facts with author Philip Longmans’ compelling human story of the loss of his wife to cancer. Part manifesto, part moving memoir, “Best Care Anywhere” offers new hope for addressing a major problem of contemporary society that affects all of us.
Also, REVIEW:
“Philip Longman makes the case that current U.S. healthcare is a fragmented, market driven system that lags behind much of the industrialized world in both quality and access of healthcare. According to Longman, the problem with our healthcare system is that it isn’t really a system and that it doesn’t reward the one thing that it should – health improvement. In fact, he offers proof that in the U.S. doctors and hospitals are rewarded for providing treatment, but not necessarily providing health to their patients. To illustrate this, he offers examples from two of the nation’s premier hospitals – Beth Israel and Duke Medical Center. Both initiated programs that were so successful at improving health that they became unprofitable and were ultimately terminated.
This book is filled with understandable, but often shocking statistics. For example, every year in the United States 98,000 people die due to medical errors while in the hospital, another 90,000 die due to infections that they get while in the hospital, and 126,000 needlessly die because their doctor failed to use evidence-based protocols for just four of the most common conditions.
The solution? Longman speaks effusively about the VA healthcare system. And rightfully so. It is the only fully functioning, evidence-based healthcare system in the country. The book explores the history of the VA and speaks honestly about some of the warts that mar the VA’s reputation. But the truth of the matter is that the VA has turned all of that around and is currently at the front of the healthcare revolution.
Longman’s book contains sections on safety, quality improvement, the concept of lifetime healthcare, and the Kizer Revolution at the VA, which dramatically improved quality and altered forever the course of veterans’ healthcare.
***
You can buy a copy of this book on Amazon, used, for five bucks. It came out in 2007.
Amazon link
How many here have actually worked in military medicine? The care is the best in the world, the administrative side and the costs leave little to be desired. Military medicine is a bit of a specialty of mine.
That’s exactly what my new friend told me the other day. He was complaining about having to spend $10,000 a year for his wife’s medical insurance, but was so thankful that he got to utilize the VA. He said he has always has the best service and most wonderful and prompt care. He is thrilled with it.
The fact that the VA is so abysmal after having been “vastly improved” shows how far it has yet to go.
And government run anything is by its very definition wasteful.
Remember the $600 hammer?
Oh here’s another one- Senate salaries. I could do this all day- how about unconstitutional “czar” salaries? Now THAT’S waste. Or, unscheduled side trips through Paris? You do know that we the people pay for his protection while he gets to gad about- probably didn’t even have to pay for anything himself/
We could cut the Presidents salary- I feel that he needs the “pay czar” to cut his pay also, so he can truly feel our pain.
BLK: “the VA is so abysmal”
DAR
See book reference above.
BLK: “government run anything is by its very definition wasteful.”
DAR
By definition? So people should just assume what you think is true because you assert it is “by definition” true.
That’s not how it works.
D.
Darrel, I go by my brother’s experience in the VA- have you used the VA? If not, shut up, as you are using anecdotal (read: useless in the real world) experience.
D- I gave you several examples of wastefulness- that you choose to ignore them reveals through your failure to address them, their inherent truthfulness.
BLK: “D- I gave you several examples of wastefulness…”>>
DAR
Oh yes, you mentioned the $600 hammer story again.
Perhaps you missed my references which directly address the VA’s superior efficiency. Again (as above):
***
“The fact is that the government-run U.S. Veterans healthcare system is now considered signficantly more efficient than private-sector healthcare according to:
The New England Journal of Medicine (”Effect of the Transformation of the Veterans Affaris Health Care System on the Quality of Care, May 29, 2003)
The Annals of Internal Medicine (”Diabetes Care Quality in the Veterans Affairs Health Care System and Commercial Managed Care: The TRIAD Study,” August 17, 2004)
U.S. News & World Report (America’s Best Hospitals, Military Might, July 18 2005);
the American Journal of Managed Care (”The Veterans Health Administration: Quality, Value, Accountability, and Information as Transforming Strategies for Patient-Centered Care,” 2004,10; part2);
Washington Monthly (”The Best Care Anywhere,” January/February 2005)
and The Washington Post (”Revamped Veterans Health CAre Now a Model,” August 22, 2005).
BLK: “I go by my brother’s experience in the VA- have you used the VA?>>
DAR
No, but I tuned their piano last month. I gave them a discount.
BLK: If not, shut up, as you are using anecdotal (read: useless in the real world) experience.>>
DAR
I am sorry you are confused. When you lean upon your brother’s experience, it is *you* who is using “anecdotal” (read: useless in the real world) evidence.
I refer to the scientific studies above. This trumps you asking “your brother.”
D.