Jack Ohman for March 18, 2010

Some people have decided to do the right thing. Just heard a congresswoman say to CNN that she’s voting yes because some things are more important than re-election, and the healthcare of the American people is one of those more important things.

If it dont work I suppose it can be kicked out when Obama gets kicked out.

If they really want to reform something, start with Torts. Fix that problem and maybe health care costs wouldn’t be so ridiculous.

^ A physician, and a Republican, Tom Coburn acknowledged publicly that malpractice reform isn’t the only cause of unnecessary medical expenses. The larger portion is the conflict of interest when physicians refer patients to facilities to use equipment they have an investment in or own outright. Yes, a Republican physician said that at the recent healthcare summit.

More than 40 states have had restrictions on torts since 2002, says the CBO. “But even large savings in premiums can have only a small direct impact on health care spending–private or governmental–because malpractice costs account for less than 2 percent of that spending.” (http://www.cbo.gov/doc.cfm?index=4968&type=0). Republicans love tort reform because it protects insurance companies (and not patients). But it’s a red herring. Approached properly, malpractice insurance reform might be of more use – and whoops, there’s that idea of straightening out the insurance industry again. Funny how tort reform doesn’t ask the insurance industry to lower their rates…

bruce, if I may dare to disagree … there is a cost to weed out waste, fraud and graft. Cost of increased monitoring, cost of investigators, etc., it may not be huge, but there is a cost.

motive’s point is well taken, true malpractice reform means more than putting restraints on people/lawyers who bring malpractice suits. it means putting limits on the delays and frivolous motions to delay that the deep pockets routinely practice, thus increasing the overall cost of the process, and in some cases, delaying long enough that the injured person dies, then the nature of the lawsuit is changed.

Greta von S, conservative, attorney and Fox News commentator, makes the very point I just made. Reform has to affects both parties, plaintiffs and the deep pockets of the insurance industry.

And you do know, don’t you, that it is NOT giving free healthcare. We have that basically in Medicaid. It’s helping those who can’t get healthcare through an employer or through an individual policy market. (The individual policy market is the most unregulated market, with the most abusive practices.)

Yes, the bill does provide subsidies for those whose income doesn’t allow them to afford high monthly premiums. But it lets them purchase that as part of a larger pool, thus lower costs. And when it keeps the uninsured out of ERs for non-emergency care, it lowers the cost for all of us, because we all pay for that now.

There are more elements of the bill that are designed to slow the growth of costs, that’s why the CBO says it will reduce the deficit that we WILL accrue if we do nothing.

I know you don’t like the pork, special deals; neither do I. But I believe this will be good for the people and for the nation. (sorry, I’ll climb off my soapbox.)

We’ve got lots of rednecks in Canada – if you might be a redneck.

I don’t know this stuff the way BCS does, by a long shot, but isn’t it one of the arguments against the reform that people can get care at emergency rooms anyway right now? Well, who pays for that? As others have posted recently, there ain’t no such thing as a free lunch, and there any no such thing as health care that doesn’t cost somebody something. The cost is offset by higher costs for the people who do pay. So it’s not as if you aren’t paying for other people already.

And insurance of any kind is a method of spreading risk around. I pay X amount of money to an insurance company on a bet that I will get X+Y back, and I hope that I will lose that bet. But somebody is going to get X+Y, and somebody else is going to get X-Y. Free enterprise redistribution of wealth.

But it’s kind of crazy to make people wait until they’re sick enough to need to go to the emergency room. Make them part of the system from the beginning, and the overall costs will go down.

Bruce, you didn’t read my post, didja? Tort reform would cover 2% of the costs. The big costs of healthcare in this country are due to a huge noncompetitive industry sitting between you and your doctor!

Bruce, why do you believe this bill will cause you to lose your union medical plan?

I know my post was long (sorry) but I tried to explain the difference between healthcare “costs” and healthcare “charges.” It helps explain why “charges” keep soaring. (And it’s true, it’s how the hospital I worked at for seven years actually operated.)

(did anybody read it? understand the point?)

I read it, I got the point, and I admired the clear exposition, and I was jealous. So there.

“Two ways to address malpractice premiums are to discipline those “repeat offender” doctors who commit the bulk of malpractice and reform the rate-setting process for malpractice insurance, Smith said. Between September 1990 and September 2002, just 6.5 percent of Texas doctors were responsible for 51.3 percent of the medical malpractice payouts. Those doctors each made two or more malpractice payouts worth a total of more than $1 billion. Just 2.2 percent of the doctors were responsible for 25 percent of the payouts, according to information obtained from the federal government’s National Practitioner Data Bank. (To read Public Citizen’s report on the malpractice spikes in Texas, go to www.citizen.org.)”

Enough with the tort reform already! Bad doctors should be kept out of the business, not encouraged to make more victims. But like motive said, its a drop in the bucket compared to the real problem.

Bruce! Have you read any James Lee Burke novels?

Your mentioning of the swamp life and fishing w/your Dad and gators has me wondering.

The Dave Robicheaux series is great if you like cop work. Robicheaux has a partner named Clete Purcell and together they light the bayou up.

If you haven’t read him, I’ll bet you would enjoy his work. I get the feeling Burke and you would be buddies.

zeke – any opinions about Stephen Hunter and the Swagger novels, father and son?

Sooky Rottweiler says; Those arms look like chew toys! Have fun, Blazin’ B!

Beebee Doodle says; ^ Just making sure Sooky doesn’t go anywhere near lonecat’s poodle without me…I’M NOT JEALOUS!!!

Beebee: My poodle just came back from a romp in the rain in the park, and she’s flat out tired. Big wrestle with a labradoodle. For a seven year old lady, she still has energy. But then she needs her beauty rest.

bruce, I understand your nervousness. But without knowing all the details of your own situation, I believe this bill would be to your benefit should you ever have to purchase health insurance on the open market, or want to purchase a supplemental plan when you qualify for Medicare.

I would imagine there will need to be “fixes” to this plan as it is implemented. That’s OK with me. For the first time in a long time, this bill does something to stop private insurance cos from basically running the healthcare train in this country, something that is neither appropriate nor medically sound.

zeke, James Lee Burke is incredible! Love his work, recommend it highly!!!! (try him Bruce)

lonecat–no, but I’ll check ‘em out. Have you read Burke?

bcs–yeah, he’s one of those authors that have me thinking “just one more chapter” till about 3 am. His dream recollections are freaky.

^ No, zeke, I haven’t. I certainly will check him out. I am not recommending Stephen Hunter. I can’t decide if I like him with reservations or dislike him intensely. He’s smart and he’s a good story teller, but there’s a kind of pornography of violence in his work that I find disturbing. Maybe he means it that way. He also knows guns inside out. (I think I’ve fired a gun twice in my life, and fortunately there was no one in the way.) A few of his novels are hack work, but some are compelling – Tapestry of Spies (I think that’s the title) is perhaps the best, but Havana is interesting. Dirty White Boys almost made me sick. Many, but not all, concern one of two police officers, a father and a son. I’m not recommending him, but I’m curious to know how others react to him.

zeke, lonecat, what other mystery authors do you recommend? I don’t know if I’ve read Hunter, but the phrase “pornography of violence” turns me off most definitely. Bob Crais? I’m blanking on other names right now.

bcs–John Sanford’s “Prey” novels are fun…His detective is Lucas Davenport, working in Minneapolis and beyond. If you haven’t read him, I recommend reading them in chronological order…I think there are18 so far.

Believable evil, in my opinion.

zeke, believe – I don’t keep up, I just don’t have time. But I’m always looking for recommendations. I tend to read crime novels more than mysteries, and I also like some thrillers, but mostly older writers – Eric Ambler can’t be beat, and Patricia HIghsmith is a great writer, though she spooks me out. In mysteries, I like Chandler and Rex Stout. I’m showing my age. I try to read newer writers when I get recommendations, but somehow I find myself going back to the old favorites.

^ try a Tony Hillerman. His mystery novels are based on Navajo characters and culture.