An American Idiot

Why is it when Obama wants something passed into law he frames the discussion as a life or death crisis? He is beginning to remind me of the little boy who cried wolf.  Speaking before the AMA, Obama predicted that if his health care program is not passed, “America may go the way of GM – paying more, getting less and going broke.“  He also described our current system as a “ticking time bomb.“  Such language is deliberately designed to cause a sense of fear, panic, and urgency.

True health care costs have been rising consistently faster than inflation for the past 2 decades.  But why are they rising?  Is it because of needless testing?  Or is it due to needless litigation?  Every new drug that makes its way through rigorous testing and FDA approval finds a gaggle of tort attorneys waiting and in fact trolling for cases of apparent complications.  Doctors are sued daily by patients who discover a serious illness after years of misdiagnosis.

As I read and listen to what the President is saying I am experiencing fear.  But it is not fear that I will die if a national health care plan is not passed but fear it will be passed.  People, please think critically about some of the things Obama told the AMA.  First, he said he wanted to “explore a range of ideas” to reduce medical testing.  This hits very close to home for me.

In October 2007 my wife had a routine mammogram and she was subsequently diagnosed with breast cancer.  She went down that horrible path of surgeries, chemo, radiation, and hormone therapy.  Along the way she wanted genetic testing.  You see we have a daughter and my wife is of Eastern European Jewish descent and naturally we wanted to know if our daughter should begin testing early or not.  We were informed by the Chemo-therapist that this was completely unnecessary and had no bearing on my wife’s cancer.  We pushed and our primary care doctor approved the test.  Under an Obama plan my daughter might not catch her breast cancer until it is too late since the genetic test would not be necessary and subsequently my daughter would find herself cost reduced out of early testing as an adult.

A year following all of her treatments the insurance company says no followup monitoring (testing) is required beyond a mammogram.  My wife’s cancer barely appeared in her breast with the bulk of it under her arm where the mammogram was blind.  So she requested an MRI to peer around under her arm.  The insurance company again said this was unnecessary but we insisted and the doctor agreed there was history to justify it.

The MRI revealed a 4mm growth that would have gone unnoticed perhaps for years – an MRI that was unnecessary by insurance standards.  Unnecessary testing may have saved both my wife and my daughter.  But in government eyes they would have been “acceptable losses” in lowering health care costs.

Obama says he does not favor limiting ligation against health care providers yet used the situation to prove the government needed to step in.  He opposes a loser pays litigation system as well.  How will a government run system limit costs?  By limiting patient access to the system.  Limiting potentially life-saving tests because they are unnecessary.  Perhaps even limiting potentially life-saving surgical procedures if the cost-benefit ratio is too low or if the long-term outcome is unchanged.

For example what should be the treatment for a lung cancer patent.  Five year survival rates for stage 1b (caught very early) lung cancer patients are bleak.  Only 50% of patients live beyond 3 years with surgery.  So why do it.  Seems like an unnecessary waste of public monies if the patient ultimately dies.  Doesn’t it?

It seems very naive to me to think that costs can be contained in any other method than limiting access to care.  Any belief that it would cut cost while expanding quality and quantity of care seems predicated on the belief in a benevolent government.  This is a very dangerous road we are heading down.

Tort Attorneys are a big part of the problem

Containing health care costs begins with controlling litigation.  Most cases are frivolous and unfounded.  If potential litigators knew there might be a cost to losing they might not sue unless they knew they had a damn good case.  I’m not simply talking about protecting doctors but actually making litigators responsible for the cost of failed litigation.  Oh but that doesn’t require nationalizing health care.  I know he says he doesn’t want to do that but even as he claims his plan is not a “Trojan horse” it bears every likeness to one in my eyes. If the federal government cannot make Medicare work how the hell are they going to make this monster work?  The government has never been able to control the cost of anything, how will creating a trillion dollar a year (that’s what I predict this will eventually cost) program contain costs or fix anything?

Here’s another idea.  Holding doctors responsible for quality of life mistakes by ending their careers after a pattern of incompetence is established.  Right now doctors can hide their past errors and may continue screwing up.  Perhaps there should be public records available of a doctor’s successes and failures?  How much does malpractice cost the health care system?  In legal costs, in added care costs, and human costs this is something that should be dealt with before a doctor has been sued multiple times.  Encouraging more testing and making those test more affordable so illnesses can be caught very early and thus saving later costs.  The only reason I can see for restricting tests is to increase the mortality rates among cancer patients thus removing their expensive treatments from the equation.

Obama is framing his case as a live or die situation so the cattle will stampede.  With the help of the media I hear the thunder of a frightened populous.  Stampeding cattle will run over anyone in their way and they will run straight off cliffs without hesitation or consideration.  It is my thesis here that Obama like the little boy who cried wolf is using fear to get what he wants.  I seriously wonder if he has clearly thought about all the implications of his own words.  Limiting testing is the dumbest way to contain costs.

I propose that the ticking time bomb and the cause of America “going the way of GM” will be the very health care program Obama is pitching now.