Whack-a-mole in the House

No sooner does Nancy Pelosi cut a deal with Blue Dog Democrats on limiting (a little) her version of ObamaCare than black and hispanic representatives say they won’t go along. What’s Nancy to do? If she gives away the country, she pisses off the Blue Dogs, if she doesn’t, she’s got every Congressman of color screaming bloody hell. She needs the votes of both groups to get any bill at all passed, but she can’t have one if she includes the other. Mongo have great pain between ears.

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25 responses to “Whack-a-mole in the House

  1. anonymous

    Gridlock is good

  2. Anonymous

    I have a new hero.
    Phil Roe has offered his time, in order to allow Obama to explain to him, the 1,000 page health care bill, on a line by line basis.
    Greta Van Susteren, a lawyer, finds the document unfathomable, and has the confidence to repeatedly admit this on her Fox News programme.

    So there lies our problem. It may take a long time, a very, very long time for Obama to explain this, line by line.

    http://www.roe.house.gov/index.php?option=com_content&task=view&id=213&Itemid=35

    Would you be so kind, on my behalf, to offer your services to Phil? To join him in deciphering the bill with your President.
    Seems like a great chap.

    ‘Fountain for Congress’

  3. Anonymous

    very catchy… and there maybe additional benefits for the citizenry…

    Fountain for Congress!

  4. HG

    A lot of the detail of health reform is going to be filled in by a panel of doctors and other medical experts at a later date. Obviously you can’t get into that kind of detail in the legislation itself, so this really isn’t a fair criticism. Decisions about when a medical procedure is just too expensive are going to have to be made by the government panel on a case by case basis. A lot of these hysterics from the right wing are just off base–socialized medicine has worked in Canada, the UK, most of Western Europe, the Soviet Union and Japan. We’re just not going to be able to afford gold-plated healthcare for everyone so the fair thing to do is to have some kind of central decision-making, with a considered approach to how to provide to each person according to his needs.

  5. Anonymous

    “Decisions about when a medical procedure is just too expensive are going to have to be made by the government panel on a case by case basis.”

    “centralized decision-making”

    “…to each person according to his needs.”

    yikes! the totalitarians are here!
    the economics of statism is looting. the politics of statism is dictatorship.

    what happened to the constitutional republic?

  6. J

    We are going to turn into the medical system in Europe where older patients are left in hospital hallway’s and are not even given a room.

    When I asked a doctor why they did this to these patients, his answer was, they do not have the beds and that these individuals led good lives and basically that we should respect their advanced age.

    They neglect the elderly to cut costs in Europe and that is what is going to happen in this country as well.

    Of course, the elderly that are financially fortunate go to private hospital.

  7. Old Atlantic

    Sotomayor has a reputation for detail. So she can decide who gets tests or treatments instead of markets. I think that is how the Hispanic and Black caucus believe it will work here.

  8. HG

    No doubt in most cases a free market is preferable, but the economics of health care are quite a bit different than the typical market. I don’t have direct experience with European hospitals but I don’t think we are talking about leaving people in hallways. It is a fact that most health care costs come in the last six months of life, so this is a prime area for savings. I think what we are talking about is probably leaving older people in a regular hospital room rather than sending them to the intensive care unit, or for example as the President suggests having some kind of age cut-off for things like hip replacements. Central planning is already practiced in the U.S. in health care–for example panels of experts decide who gets donor organs. I am not sure whether this is addressed in the current legislation, but I think in many countries there are pretty strict restrictions on going outside the state-run system. To avoid a two-tier system I think we are going to need to have rules similar to the UK, where in many cases you are prohibited from buying extra health care from your state-controlled doctor.

  9. anonymous

    Compare the healthcare quality of a $150K/yr worker at some $100+Bn mkt cap co. in suburban NYC or Silicon Valley vs same income, insured worker in suburban London or Frankfurt

    Compare healthcare of a $5MM+/yr trader in NYC/Greenwich vs counterpart in London or Frankfurt

    Are all physicians created equal? Are the $1+MM/yr cardiologists/surgeons at US’ best private practices more talented than a $150K/yr gvt employed “doctor” or some low-income doctor who accepts cheap HMO pmts?

    Top 1% pay ~50% of taxes

    Suspect top 1% of hc consumers tend not to be taxpayers at all and often have many self-inflicted chronic diseases like obesity, diabetes, hypertension, lung cancer, etc

    Why should relatively healthy top 1% of taxpayers pay for poor lifestyle choices of others?

    More Darwinian selection is ultimately more healthy for the US economy than greater or communist-style hc coverage

  10. Anonymous

    HG is for a dictatorship and euthanasia.

    restrictions on going outside the “state-run system,” are you serious?

  11. J

    HG; The federal system will be full of politics and favoritism. Lets see your are nice contributor to our party, you get a new organ.

    The elite/politicians of Europe do not mind their health care system bc they go to private hospitals or fly to the United States to receive care.

    Government does a lousy job in whatever endeavor, besides possibly the military, they control. What makes you think this will change?

  12. HG

    I am not in favor of a dictatorship. The Obama administration has a mandate to get health care reform done. Fairfield County went for Obama. Greenwich went for Obama. High income areas of the country went for Obama in overwhelming numbers. So the fact is that the Party is looking at what the public has asked them to do–and not just your top 1% of health care consumers with self-inflicted problems, but your $5 million / year traders, too. In terms of euthanasia there is a pretty big difference between actively ending someone’s life and simply not providing a trip to the intensive care unit and / or a hip replacement. A lot of extra government money is going to be spent on preventive care, like nutrition, which would address some of your concerns about self-inflicted health problems among the poor, and you can start to see movements toward taxing soda, outlawing certain types of vegetable oils and calorie disclosures on menus also making a contribution so hopefully we don’t have to cut back on major medical care. Finally, I think the Administration has indicated they want to keep the maximum amount of choice in the system, but the problem other countries have experienced is that the most skilled doctors and the most motivated nurses, etc, will move out of the government-dominated part of the market into a second ‘tier’ where the rich pay cash. Even if this is not part of the initial reform, eventually they are going to have to make it difficult for doctors to practice outside the main ‘tier’ where government pricing can keep costs down, otherwise you lose the best doctors. I think when you size up the situation, you really can’t say that reform is being ‘dictated’ to the people after they voted so clearly in favor of it–you would have to argue that the high income blue-staters voted on other issues or were not well educated on the healthcare issue (their #1 issue).

  13. Riverwich

    Dodd Diagnosed With Prostate Cancer, Hartford Courant Reports

  14. Anonymous

    HG worships the (failed) religion of central planning and control.

    HG hasn’t looked at the recent polling on healthcare, and ignores the fact that many of the promises made by BO including governing moderately from the center and not being a big government tax and spend Democrat to gain centrist and independent votes were blatant lies.

    “…you would have to argue that the high income blue-staters voted on other issues or were not well educated on the healthcare issue (their #1 issue).” yea, that or they drank the kool-aid and were lied to.

  15. J

    HG; Are you going to explain this to the people that are waiting in line to enter an ER rooms for hours to see a doctor? Or the person that will wait three months to see a specialist? This is going to be reality

    You must admit there will a shortage of good doctors since many will work for the pharmaceutical companies and/or form private partnerships (own their own private hospitals) and not accept the govt coverage, then you will see the crumbs of the profession accepting the govt insurance.

    If this is such a great system why doesn’t’s the Congress adopt it as well?

    They will never do same since they are part of that same elite (like in Greenwich, Ct) that will always have better options.

    Why isn’t something done relative to tort reform? Nothing is done because the trial lawyers have such a strong grip over the Dem party.

    We all agree that the medical system needs change but not what is offered.

  16. HG

    I am a free marketeer everywhere but on this issue. There is some kind of momentary reaction in the public opinion polls where people look at the new plan, there are concerns, most people have insurance, most people have decent health care now, etc, but the fact is that this is a 20 year build-up where people have gotten on board with the idea of some kind of government plan.

    In terms of efficiency, the Chris Dodd story is a great example. Prostate cancer is one of the most treatable cancers and survival rates in the UK are almost as good as in the US. In the UK you get prostate surgery; in the US you get prostate surgery. Presumably in the UK the surgeon makes less, so the savings is generated by cutting into the provider’s profit margin. I am not sure about wait times. Another area of savings is pharmaceuticals–I believe in the US, Avastin is prescribed for treatment of some breast cancers, but it is incredibly expensive. I think the UK panels have found cheaper, nearly-as-effective treatments as standard-of-care (on top of that, once the government is able to negotiate prices directly with the pharma companies, legacy medications like Avastin will become affordable; i.e., pharma profit margins). I am an amateur economist so unlike many people, I realize there are costs here (less pharma R&D, some doctors will retire early), but there is a pretty big one-time gain from cutting the profit margins of doctors, pharma, nurses, etc who have sunk costs (training, past R&D on existing drugs) and are stuck in whatever system emerges.

    I agree trial lawyers vote Democrat, and I also agree you’ve got to prohibit medical malpractice suits altogether (this is one area where the Republicans were right). But the fact is, most doctors I know, including very skilled, highly paid doctors in the NY metro area, voted for Obama even though physician pay has been in secular decline (due to Medicare reimbursement rates), the health reforms will almost certainly bring pay down more and on top of that they are likely to pay significantly higher taxes on their remaining income. So I think opponents of reform are swimming against the tide.

  17. Anonymous

    the Stasi are here.

  18. J

    Opponents maybe swimming against the tide, but that tide will change when the health care reforms, if institured, fail, and the 2010 congress will then bleed red.

  19. HG

    J, I agree with you, the Republicans probably make gains in Congress in 2010. As a fan of the blog and the excellent real estate info, I would even consider rooting for CF against Himes in the CT 4th district (by then health reform will be irreversible, like a well executed vasectomy).

  20. Anonymous

    HG – socialised medicine has not worked in the UK. patients in the US being treated for prostate cancer and other cancers are 4-1 more likely to survive than UK patients. Go talk to ill patients in countries with socialised medicine and you will get a completely different story than the being fed to you by the leftists and their beholden media.

  21. ogrcc

    what do you guys work for the health insurance companies??

    it is obvious people are AFRAID of socialised medicine.

    turn off the faux news

    US healthcare is ranked 37th

    socialised healthcare > for profit healthcare

  22. Another anon

    HG, talk to doctors in northern Michigan, heck, in any northern border state and ask them how many Canadians cross the border and seek private treatment in the US rather than wait 6-9 months for their state system to approve or deny their care.

    For that matter, google how many US citizens on the southern border states used to cross into Mexico for prescriptions and dental care before the border crackdowns occured.

    Anectdotally, I had a co-worker who went to Costa Rica for a facelift because it was so much cheaper than having one done in the US. As far as facelifts go, it looked as good as one you’d get in the US, so there you go. The only way you’ll get “the same treatment” is to close the borders. LOL.

    Another point, would you deny Senator Dodd prostate cancer treatment because he’s had a good life? I can only imagine how my high school friend’s family and the community would have reacted had their 10 year old been denied care for leukemia in the last six months of his life. Is 10 a long enough life? 50? 70? Who are you to play God and decide who’s had a long enough and good enough life to receive medical treatment or not?

    Jeez, I am really shaking my head over your comments.

  23. Anon @12.24

    J,
    Did you consider whether private hospitals will be prohibited?

    Has anyone thought whether Medical Students/ Interns /Junior Doctors would have to sign a contract like the Military, dictating length of service, to offset training costs. Nurses presumably would be required to do the same. They have certainly evaluated this option in the UK.

    HG,
    I believe that “you’re ‘aving us on”, playing devils advocate.
    No one could keep a straight face when writing all that…. AND personally voting Fountain into Congress. It’s a great idea. Go for it.

    I have experience of UK, Canadian and US healthcare systems. I can promise you that the UK system does not work well. The Canadian care was appalling, and in Russia, they routinely ‘loose’ you.

    With regard to hip replacements, the younger the patient undergoes surgery, the more are required in their lifetime. The replacements have been a ten yearly appointment, much like breast augmentation, they both fail over time.
    So, the younger the patient, the more blame should be attributed to him and the less deserving he would be, according to the philosophy that you are triumphing. Hip replacements ‘should’ be therefore, only reserved for the ‘suitably’ elderly.

    Do we restrict neonatal care?
    The funniest thing that I have heard since my arrival in “the greatest country in the world”,
    was that “Obama’s top science adviser, John P. Holdren, said in a book he co-authored in 1973, that a newborn child, with “sufficient nourishing food during the crucial early years after birth, will ultimately develop into a human being”

    http://www.cnsnews.com/public/content/article.aspx?RsrcID=51676

    Wow! This clearly calls into question whether the newborn is entitled to any rights or health care. Hopefully, HG has passed the age of family and grandchild raising. Up to one in ten babies born are premature, requiring neonatal special care, this is also an area which may be targeted or, made unavailable unless paid for in advance of treatment.

    http://www.marchofdimes.com/professionals/14332_1157.asp

    “It is a fact that most health care costs come in the last six months of life, so this is a prime area for savings”.
    Duh!! If the end of life comes whilst having any kind of treatment in hospital, that would clearly have been your last six months.
    Expensive but failed treatment.
    Treat for an intracranial haemorrhage, renal transplant, Aortic aneurysm, tricuspid valve replacement, Wertheim’s hysterectomy or any other ‘routine’ but dangerous operation, and it may well contribute to the greatest health care costs. Obvious really.

    Is your (fake) argument that we actually don’t treat anything except possibly lasering some tonsils, which even your leader has stressed is also unnecessary?

    In conclusion, don’t risk your life waiting for treatment in the UK, if you can help it. Don’t take your 8 month old baby to Canada for fear of needing emergency healthcare, and don’t have a car crash in Moscow.

    Most importantly, HG is an eloquent troll whose alter ego we all know well.

    ‘Phil Roe MD. for President’
    ‘Fountain for Congress’

  24. HG

    I would not deny Sen Dodd a prostatectomy, but I do think we have demonstrated it is possible to cap the price of the procedure since the price for this procedure, and many others, is already set by the government.