Command Control Health Care
Obamacare/socialized medicine advocates deny that they support rationing, insisting they will increase access to care. They deny they will interfere with the patients' choice of doctors or insurers. Recently, we've already seen real world consequences exposing the proponents' lies, e.g. the 111 exemptions from Obamacare granted by the health care central planners, and this monstrosity has barely begun.
It is beyond me how anyone can believe that a more centralized health care system could possibly increase patient choice or quality of care. But it's even more incredible when you consider Obama's appointees and mentors in this area. He originally tried to appoint former Sen. Tom Daschle as Secretary of Health and Human Services, probably in large part to Daschle's thinking on health care.
Some say Daschle's ideas led to the creation of the Federal Coordinating Council for Comparative Effectiveness Research, a $1.1 billion board allegedly constituted to make health care decisions. One of the council members is Rahm Emanuel's brother, Ezekiel Emanuel, a physician who strongly agrees with Daschle's statement that health care reform "will not be pain free." Emanuel said, "Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years."
Even more alarming, is Obama's recess appointment of Medicare head Donald Berwick. Surely most here have read about Berwick's love affair with the British system ("I am romantic about the NHS; I love it. All I need to do to rediscover the romance is to look at health care in my own country."), and his belief that health care systems should be vehicles for societal wealth redistribution ("Any health care funding plan that is just, equitable, civilized, and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional.")
It turns out those are not the only disturbing gems from Berwick on health care. Berwick's affinity for health care as a vehicle for wealth redistribution is obviously not the only reason Obama wants to avoid the scrutiny a bona fide confirmation inquiry is designed to produce. In a piece in First Things, Wesley J. Smith reports that Berwick also wants to do away with 80% of "dinosaur" patient/doctor office calls.
Smith says that in a document Berwick wrote before assuming his current position, he glowed about increasing patients' access to care, saying it could "be summarized in one phrase: '24/7/365.' The access to help that we will envision is uncompromising, meeting whatever need exists, whenever and wherever it exists, in whatever form requested."
But if you look a little closer you will find that Berwick would achieve this Utopian-like expansion of access only through an Orwellian redefinition of terms. As long as you exclude patient/doctor visits from your concept of access, you can greatly expand access ("Access 24/7/365 begins to be achievable only when we agree ... that the product we choose to make is not visits. Our product is healing relationships, and these can be fashioned in many new and wonderful forms if we suspend the old ways of making sense of care. ... The health care encounter as a face-to-face visit is a dinosaur."
What is most striking to me is not Berwick's opinion that patient/doctor visits are an undesirable relic, but that he seems to believe that government/bureaucrats ought to be making these types of decisions. The mentality of socialized medicine advocates such as Obama and Berwick, is that the command/control model is desirable for health care. Obama's belief that government should make health care decisions was on full display when he talked off-prompter in his 2,600 word, rambling answer to a lady named Doris, at a town hall meeting in Charlotte, N.C. Obama said, "If you go to the doctor you get one test. Then (you are) referred to a specialist, you get another test. Then maybe you go to a third person, the surgeon, you get a third test -- it's all the same test but you're paying three times. So ... we'll pay you for the first test and then e-mail the test to everybody. Right? Or have all three doctors in the room when the test is being taken." (How would you like Obama making your health care choices for you?)
Everything about Obamacare screams that government's already excessive role in health care choices will grow exponentially under this new system and that patients' choices will correspondingly diminish.
You can't possibly have a command-control system -- and that's where we're headed -- without reducing freedom, including patients' choice of doctors and insurers and the doctors' and patients' ultimate control over health care decisions. That's why socialists like Berwick and Obama have to distort the language and misrepresent the facts in presenting their arguments. If people truly understood the thinking behind these statist ideas, Obamacare wouldn't even have the level of paltry support it has.
In effect, Obama sold a system guaranteed to diminish access to care and choice as a benevolent system that would greatly enhance access and choice.
And liberals accused Obamacare opponents of misrepresenting and scare tactics. Truly surreal.
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Comments :
Aug '10
Re: Command Control Health Care
It's appalling that they're not more ambitious. I mean, how can you stop at health care? Look at all the hunger in America, starving kids and such. Don't we have a right to health? That MUST include food.
We should have 'grocery care'.
What about housing? Look at all the homeless, and the children stuck in substandard housing! Don't we have a right to good housing? You can't be healthy without a good house.
We need 'housing care'.
Good jobs are absolutely a requirement for good health, too.
We need 'job care'. It's really all for the children. It's an investment in their future.
These Liberals are such pikers!
Oct '10
Re: Command Control Health Care
Absolutely - the government should be not only delivering our food, but cooking it without trans-fats.
I am a relatively affluent Canadian, and if I want to see my doctor, I can book an appointment (currently booking in January), or I can attempt to see him at the clinic where he is on call two afternoons a week. To see him, or another doctor on the days he is not available, I need to line up outside the clinic, starting around 7:30 a.m., to hope to get an appointment that day. And all the horror stories you hear about waiting lists are true. It is insane - but once instituted government health care is impossible to eradicate.
Sep '10
Re: Command Control Health Care
And all the horror stories you hear about waiting lists are true
The best part about Canadian healthcare is that dying while you wait improves the government's health care statistics.
Edited on Nov 21, 2010 at 3:09pmJul '10
Re: Command Control Health Care
Well, who needs an over-involved diagnosis anyway? As long as I have a first rate "healing relationship" with my caregiver I'm good. I mean, there's no reason I shouldn't just email in my problem & pick up my scrip.
Oh, I thought this was a thread about medical marijuana...
Oct '10
Re: Command Control Health Care
And dying is something we all do, so it is nice and equitable, and altruistic.
Oct '10
Re: Command Control Health Care
We do, in lieu of actually seeing a doctor, have a 1-800 number we can call 24/7. Berwick's dream is my nightmare.
Jun '10
Re: Command Control Health Care
Does anyone believe that these advocates of re-distributional health care would apply this "equity" to themselves? Fairness is always for us others. It is always us who need to use less energy, turn down our thermostats in the winter, die sooner. For them it is 72 degrees all year long and private jets, and heart replacement at age 90.
May '10
Re: Command Control Health Care
Actually, the primary care model is indeed obsolete- Berwick is right about that. His directed solution is what is the problem. If health care was returned/converted to an actual retail marketplace, many changes would occur, significantly affecting (reducing) the cost of the most common actions- and the patients would be fine with that because it would be their rational economic choices.
The problem is that this is dictated from the top-down and badly designed by control freaks. The Berwick approach is AT&T controlling everything in the phone business with mundane technology and costs rising. The alternative is today's telecom market. When medicine is allowed to innovate that way for consumers instead of competing to game the system for reimbursements, we will see amazing differences.
Medicine is the most old-fashioned and hide-bound industry in the world.
Edited on Nov 21, 2010 at 7:15pmSep '10
Re: Command Control Health Care
Not to mention quiet. The dead cause few punch ups at airports.
Nov '10
Re: Command Control Health Care
Obamacare is bad in more ways than anyone can count. Medical decisions that affect people's lives will be made by bureaucrats who are stupid, amoral, unethical, unprincipled and utterly ignorant of medicine. The potential for abuse and corruption is almost unlimited – and terrifying.
Suppose a selfish twit is waiting for his inheritance from Grandma, who is currently 90 and looking much too healthy. If Grandma went into the hospital for a relatively minor operation, how difficult would it be to bribe an Obamacrat to make sure that certain life-saving procedures were withheld? Costs must be cut somewhere.
Rationing will be a given. But Obamacare will be doled out strictly according to political guidelines. If you are a member of the Tea Party (or any group perceived as unfriendly to Democrats), you will get precious little care. You will be lucky if you can get an aspirin while you pass a kidney stone. For purely political reasons, it is no loss if you die. Costs must be cut somewhere.
The same kind of people who run the Post Office will run your healthcare. If that is not a perfect prescription for Nightmare, I do not know what is.
Edited on Nov 22, 2010 at 3:32amMay '10
Re: Command Control Health Care
Xty: Absolutely - the government should be not only delivering our food, but cooking it without trans-fats.
I am a relatively affluent Canadian, and if I want to see my doctor, I can book an appointment (currently booking in January), or I can attempt to see him at the clinic where he is on call two afternoons a week. To see him, or another doctor on the days he is not available, I need to line up outside the clinic, starting around 7:30 a.m., to hope to get an appointment that day. And all the horror stories you hear about waiting lists are true. It is insane - but once instituted government health care is impossible to eradicate. · Nov 21 at 2:37pm
I'm only an average income Canadian and it's worse than you describe where I live. It's a community of close to 20,000 and we just started delivering babies locally after having had no obstetrical care for almost 2 years. Having a baby? Hope you like driving 75 minutes (each way) to your appointments. And to deliver.
Sep '10
Re: Command Control Health Care
The reading of posts on the evils of Ocare is becoming more and more tedious. The country has been moving toward socialized medicine since WWII when employer sponsored prepaid medical care(erroneously termed insurance) was introduced as a response to wage and price controls. Both parties were complicit in this pervasive movement against market control. I agree with all of your points and hope Ocare is repealed, but if it is, I feel certain what we will be left with is a system that is less market oriented than what “The Compassionate Conservative” wrought. This will be termed victory by conservative pundits as we continue moving down the same road toward socialized medicine. It would be nice to read something on what a market oriented approach would look like, how treatment would be provided for those on the lower rungs of the economic ladder, and how we move from here to there.
Oct '10
Re: Command Control Health Care
A market approach would look like what we used to have in Canada - you paid your doctor. If people on the "lower rungs" get the same treatment as people on the upper rungs, incentives fail. Poor people got worse care, but they would still be treated in hospitals if very sick. Sorry to bore liberal jim with my nightmare. Just because something started after WWII is hardly a reason to accept it. The market version has problems, but they are less than the socialized ones.
May '10
Re: Command Control Health Care
Not quite, Xty. Consumer-driven care is definitely an essential part of the solution. But the incumbent health care establishment is as rent-seeking as any other group in America, and the ambulance-chasers lobby is the other problem.
The medical care establishment (hospitals, caregivers, FDA, edical schools, drug companies, device providers, etc.) are at least as interested as any other special interest group in using licensing and government regulation to push prices up and keep competition away.
Unless there are pretty revolutionary changes there as well, any attempts to save money on any kind of health care are hopeless. If National Review was interested in good debate, they would make thelate Norman Macrae's 1990 (or so) NR article, "The Good Health Guide" available on-line.
Aug '10
Re: Command Control Health Care
You are, of course, right about the problems originating in the WWII adaptation to price controls. I wasn't aware that conservative pundits who had thought deeply on the matter said anything otherwise -- certainly, I've read of the origins of our "health insurance" system (tied to your job even though severe illness may make even the best of us unemployable) enough times for the message to sink in.
We would both probably agree on much of what was bad about health insurance pre-ObamaCare, and perhaps even agree on ways it could've been fixed.
Still, have patience with those who are focused on ObamaCare now: our health insurance system hasn't been fixed by being broken even more, and that this outrages people could be the beginning of the road to real reform.
And if reading the posts on ObamaCare bores you, there are other posts to read.
Edited on Nov 22, 2010 at 2:38pm