Saturday, May 9, 2009


Editor's Comment: The following excerpt is important to the debate "That is where the difference between health care and medical care comes in. Medical care is what doctors can do for you. Health care includes what you do for yourself." This is very important and any plan needs address this head on." There is a movie review.

It was Stossel's Medicare segment....The greatest shift in financial burden in our country's history. Future Medicare obligations already total the current cost of the Iraqi War x 5. Any analysis as to whether Medicare is more 'effective' than private insurance must include the government's own inability to manage the exploding future obligations it continues to create.

People who believe in "universal health care" show remarkably little interest — usually none — in finding out what that phrase turns out to mean in practice, in those countries where it already exists, such as Britain, Sweden or Canada. In these and other countries, it means having only a fraction as many MRIs and other high-tech medical devices available per person as in the United States.In Sweden, it means not only having bureaucrats deciding what medicines the government will and will not pay for, but even preventing you from buying the more expensive medicine for yourself with your own money. That would violate the "equality" that is the magic mantra.

Those who think in terms of talking points, instead of trying to understand realities, make much of the fact that some countries with government-controlled medical care have longer life expectancies than that in the United States. That is where the difference between health care and medical care comes in. Medical care is what doctors can do for you. Health care includes what you do for yourself — such as diet, exercise and lifestyle. Even for things that take longer to do you in — obesity, alcohol, cholesterol, tobacco — doctors can tell you what to do or not do, but whether you follow their advice or not is what determines the outcome.

When it comes to things where medical care itself makes the biggest difference — cancer survival rates, for example — Americans do much better than people in most other countries. I totally agree that a change in the landscape is needed. But any change must effectively deal with the enormous problems bureaucrats bring to the table as well the huge segment of the population(doctors,lawyers, and PATIENTS) that exploit the current Medicare/Medicaid system.

And considering how well the Federal Government has handled any "crisis" over the last 35 years, I not convinced at all that it is capable of producing any solution that does ultimately turn out to be a greater problem for future generations. Respectfully submitted,CD


BobbyWC said...


Thanks for a great post. I agree 100% - each of the problems you addressed are important to finding a meaningful solution.

On medicare, the primary problem is not denial of services, but as you said the future costs.

I am watching the new model of healthcare delivery being used by the VA. VA Hospitals are not the answer. Veterans in the valley are very lucky to have this new healthcare system. It is top of the line across the board.

The VA does have some rules concerning certain medications which require the specialists in SA to approve of same if necessary. But it is doctors making the decisions not paper pushers.

It is not cost effective for the VA to pay a specialist 200-300 for every veteran they see. It is more cost effective to simply have one on staff. At the VA hospital because they use students, it takes months for a veteran to receive adequate care. The endless testing these doctors in training use costs the taxpayers a forture. This is why I am opposed to VA hsopitals.

President Obama has promised, and the majority of Congress in both the Senate and the House agree, everyone must be allowed to choose their own insurance and own doctors if they so choose.

Even at the VA, if the specialist will not approve a particular brand name of medication, my doctor is still free to give me the prescription so I can fill it at my own expense.

The cost problem with medicare is the costs of allowing seniors to see their own doctors. If you are dependent on government sponsored healthcare services then I think you should agree to be seen in government clinics. This will cut the cost of healthcare delivery significantly. Again it is cheaper to have seniors be seen by a staff cardiologist than to pay for the same seniors to see a private cardiologist.

These seniors should be free to maintain their own private insurance so they can see private care specialists, if they so choose. I cannot stress enough, I am 100% opposed to any system which denies anyone the right to choose private insurance or their own doctor.

But, you cannot ask the taxpayer to fund your healthcare and demand 100% choice. If you want choice, buy private healthcare insurance. If you have no insurance and cannot afford it, then you should be happy with a government clinic.

We can set up a checks and balance system to be more effective in getting rid of the bad doctors and staff. I will tell you my main doctor loves working for the VA - she is a real doctor - real doctors love the fact that when they order blood work they can have their patient get the blood work right there at the clinic - the same goes for x-ray's and MRI's (they are installing the MRI as I type)

At the VA, under the new system for the Valley it took one week from the day my doctor decided my angina required I be seen by a cardiologist to when I had the appointment. One week after that I was with the cardiologist.

There is a little quirk in the sytem about how you get testing done as recommended by the cardiologist, but that can be fixed. But I can say that within a month of the cardiologist recommending I undergo a new nuclear medicine stress test, I will be taking the test. Had he deemed it a medical emergency, he had authority to have me admitted to VBMC in Harlingen. Key here is, he is being paid as a staff member and not as an outside specialist.

We need to experiment with healthcare delivery, Part C prescription care has to go. It will not be easy - seniors will rebel because lobbyist will pay for commercials claiming the end of the world.

The government needs to set up a national pharmacy and buy these medications in bulk at discounts. The VA renews medications by mail. I can call or go online to my account. It is more cost effective for the VA to have a handful of centrally located distribution centers than to staff an endless number of pharmacies.

CD, again thanks for a great post which gets people thinking and which brought essential facts to the table

Anonymous said...


Although I disagree with many of your posts, I appreciate the opportunity to engage in true constructive debate. The typical ignorant nonsense that dominates other area forums serves nothing more than to prevent any meaningful discussion.


BobbyWC said...

Remember I havwe always said it is about ideas - you or anyone else are free to challenge what I say -

You did it in an informative way which presented essential facts and ideas - this is when BV is at its best - I would love nothing more than for half the posts to come from readers and contrary to my own - this way people can think for themselves about the issues

Bobby WC

Anonymous said...

CD, Thank you.

"Those who think in terms of talking points, instead of trying to understand realities".

Relate the border wall to government run health care. A very simple solution to a very complex problem. NOTHING is ever that simple.

Back when Bush was in office, we would ask his detractors who pined for universal health care which agency of the government they believed was operating the best.

The response was usually a diatribe about how much government (at least one under an administration they hated) sucked and were incompetant, incapable and corrupt.

You then ask, which agency would you like to decide whether your health problems merited care or not?

This was met with a silent response of "blink-blink".

Yeah, that's what I thought.

Anonymous said...

Interesting and good to see you opinion about the VA hospital situation. I think I remember when you were all for having one in the Valley but I may be mistaken. What they have for you now makes sense to me.

Rogelio Guevara said...

Change you can believe in, you better believe it.
Remember no improvement can happen without change, but change does not gaurantee improvement.
Be careful what you wish for, you just might get it

BobbyWC said...

I believe a VA hospital is teh perfect example of be careful what you wish for, because you may not get what you think you are wishing for.

Bobby WC

Stan said...

"it means not only having bureaucrats deciding what medicines the government will and will not pay for"

Fact is, if you substitute "insturance company" for "government" in this clause, you are describing what goes on here now.

Just a tidbit on the way by.

Anonymous said...

A fair point, Stan. But there is a not so subtle difference brought to the table with that noun substitution. Insurance bureaucrats spend premium and/or investment return dollars where as government bureaucrats spend TAX dollars. Sources and uses of capital


BobbyWC said...

Can we agree on two things - the problem with healthcare is about cost, and people other than your doctor deciding on what tests you need or which medications will best treat your problem.

I will add to this, something CD focused on - people taking responsibility for how they take care of their bodies.

So now we have a focus on the problem.

I do support 100% private health insurance for those who can afford it and choose it.

But for those who want government payment or subsidy should they not be required to accept something similar to the new healthcare delivery system we have in the valley for veterans - a government clinic?

My doctor decides if I need a test and then forwards the request on to the specialist in SA or Harlingen - the local specialists are seeing veterans without any denials.

The key to cost is - they are staff on a set salary - the VA limits paperwork - the VA provides support staff - teh VA buys the medicines in bulk at a substantial discount -

How would this be bad for medicare and medicaid patients - For me it is wrong taxpayers money is being used to pay for private pay doctors - medicaid, medicare, and veteran care should all be government clinics with staff doctors - this would cut costs significantly

Bobby WC

Anonymous said...

Solid infrastructure concepts, BWC. Any solution should include a huge dose(no pun intended) of preventative care and/or motivation. Chronic conditions and their subsequent treatment plans have significant long term costs. Apologies for having somewhat of a narrow focus on this issue, however OMB data clearly shows a significant shortage of current 'contributions' relative to future obligations. Unless the fundamental equation is altered, I do not see how the citizens of this country could avoid another round of asset seizure. Even if your sensible cost cutting ideas were implemented.


BobbyWC said...


I think you are 100% correct - we must address costs, which i swhy for medicare, medicaid, and VA I support government clinics as a way to save money. I would not even mind paying $500.00 a month

Obam has put a lot of emphasis on preventive care - he seems to understand the issue

my fear is any meaningful change in the system to save money will mean politicians being voted out of office - this means politicians not being willing to vote for teh changes

This is sad

Bobby WC

Anonymous said...

Sad but true!! The last civic leader I encountered who was willing to be part of something bigger than himself/herself was the late, great Barbara Jordan. Her keynote at my undergraduate commencement consisted of two words, literally. In her eloquent, booming voice she repeated these two words over and over again,"Convictions....Values."



Anonymous said...

Oh.. and Stan; do I get my choice of governments? I do get my choice of insurance companies though, don't I?

Didn't say that the system was perfect, but the idea of turning it over to the government that we all seem to rail upon for one thing or another on a daily basis doesn't seem like an option either.

Who gets it? FEMA? DHS? CDC? How about we combine HHS with FEMA and CDC?

This just keeps getting better. You do that and at least DHS is no longer on the b ttom of the totem pole.

BobbyWC said...

As I have said before, and President Obama said this morning = everyone who wants to keep their private insurance will be allowed to keep their private insurance =

this idea of the government taking over everyone's insurance is just a con argument

on the issue of the government doing everything wrong = cool - so the military is a total failure - law enforcement to protect us from terrorists is a total failure -= - it is total bullshit to claim everything the government does is a waste and ineffecient.

Let's see what happens to commerce the day the government stops maintaining the IH system

Bobby WC

Anonymous said...

For the record Stan and Bobby...that last anony was not me.