Charles Krauthammer’s wrote insightfully and was cited here on his comments on the realities of medical care and the myths that drive current plans.
However, there are more myths than even Dr. K is aware of.
Dr. K quite properly pointed out there is no reason to believe that emergency department visits will decrease with a single payer universal coverage. After all emergency care is convenient, high tech loaded, health care. Dr. K takes down two other silly ideas like the overrated value of the electronic medical record and the overvalue of insurance coverage, even pathetic Medicaid.
My thanks to Dr. K, a wonderful essayist. He allows me to introduce a comprehensive review of many more myths of the healthcare reform geniuses and elites who are clueless about how healthcare really works and what will and won’t solve problems.
I have 42 years of physician and even healthcare consultant and executive experience, so I bet I know some things that pinheads don’t know.
First our salute to Dr. K.
http://junkscience.com/2014/02/08/krauthammer-on-science/
Obamacare is Managed Care on Steroids.
But managed care fell on its face a long time ago. I know, I was there. I ran a Federally funded and certified HMO in the early 1980s.
The Myths of Managing Health Care April 11, 2010 American Thinker
By John Dale Dunn MD JD
http://www.americanthinker.com/2010/04/the_myths_of_managing_healthca.html
In the essay I take Krauthammer’s list and expand it to the total reality. He is not involved enough in the issues to know all the silliness and bad ideas. He said the right things, as far as it goes.
Here’s a list of myths to consider from my AT essay in 2010, warning people about the craziness of Obamacare ideas.
From the essay:
Comprehensive Healthcare Reform Myths
Private insurance companies are bad, government good.
This myth is part anti-capitalist, part statist. However, sixty years of government tax rules and mandates has destroyed free-market insurance and increased health costs. Economic good sense is out the window in a mandate-controlled, third-party-payer system. A free lunch will result in a crushing tax and debt burden.
Amy Finkelstein of MIT has shown that Medicare and Medicaid independently and significantly increased health care costs by distorting markets and increasing utilization, but also by causing cost shifting.
The uninsured numbers prove that America has failed.
Uninsured is a choice, not a disease. For the truly needy, America has charity care and a Social Security Title 16 and Title 2 safety net. Devon Herrick shows that the uninsured numbers are exaggerated by the advocates, but even so, most uninsureds are healthy, and if they get sick in America, then America takes care of them.
The head of financial services at the Cleveland Clinic ruined the president’s drama about a lady with leukemia by explaining that she was being cared for and qualified for Cleveland Clinic’s generous annual 100 million charity care and Medicaid because she was a working citizen. America takes care, and the safety net works.
Uncompensated care is ruining any chance of fiscal integrity of the health care system.
America spends 2.2 trillion dollars annually on health care. The uninsured care cost is less than 100 billion, less than 5%. Crisis? Jack Hadley in Health Affairs explains that the uninsured are not a sick group. The system is expensive, but it works, with adequate safety net provisions for the needy.
We need to stop wasting money on emergency departments.
The total cost for emergency care in the United States is less than 5% of the total of $2.2 trillion America pays every year for health care. One hundred and twenty million visits, insured and uninsured, billed for $120 billion. Most of it paid for with insurance or cash. Crisis? Again? Emergency departments are convenient, open 24/7, and they offer access to high tech resources. Universal insurance will not reduce E.D. use because in a reformed system, it will be free to the patient. Robert Samuelson insightfully discusses these things in the Washington Post.
Reformers will use computers and make everybody’s health record on a government databank, resulting in better care for all.
Computers are expensive, take providers away from the patient, magnify mistakes, and don’t reduce costs. Computers don’t take care of patients, systems crash, data decays and is not securely private. Computer problems that cause errors have not yet been solved.
Comparative effectiveness panels and guidelines writers will save money and improve care.
The guideline and practice control projects will provide a way to ration or deny unapproved care for economic or medical reasons, but evidence does not show better care. The Leap Frog project in one thousand hospitals was reported as a disappointment by Leslie Kernisan in JAMA.
Lack of insurance is a killer.
The president and others wave the bloody shirt of a 2009 study claiming that a lack of health insurance causes 45,000 deaths in America per year. John Goodman and William Tate both exposed the study as irresponsible and flawed propaganda by Woolhandler and Himmelstein, unreliable and self-declared fanatic advocates of socialized medicine. In contrast, Dr. Steven Asch and Drs. Helen Levy and David Meltzer find no real benefit to health outcomes from health insurance.
New preventive care projects will save money and lives.
Preventive health myths flourish in spite of the evidence. Michael Fumento in National Review and Joshua Cohen in a comprehensive medical journal review report that claims of preventive care benefits are exaggerated and unimpressive in reality, and there are downside risks to screening healthy populations.
The American health care system isn’t safe. Government needs to intervene and punish and penalize hospitals, nurses, and physicians.
The only comprehensive American hospital care patient safety studies over four decades show a rate of negligent patient injury less than 0.25%. Denigrating health care providers and hospitals promotes the savior role of nine-to-five government mandarins with clipboards, furrowed brows, and red pencils. Government experts as guarantors of safety and quality may be the biggest myth of all.
We are in the last stretch of the hijacking, intended to create a command-and-control health care reform by a mean rank of self-assured tyrants, monitoring and intruding into every nook and cranny of American life. Health care will open the door to the state dictating living and lifestyles. Those in charge will meddle and mandate to affirm their power, sense of superiority, and good intentions.
Eric Hoffer, longshoreman philosopher, said, “The intellectuals and the young, booted and spurred, feel themselves born to ride us.”
Ronald Reagan warned that a federalized medical system would be the key to making America a socialist state. He said, “Freedom is never more than one generation away from extinction.”
Soon these remorseless, arrogant, socialist, dome-headed apparatchiks will be tallying and monitoring Americans lives in their journals, recording new orders and mandates, chronicling oppressions and terminations. Harshness will characterize their regime.
Liberty will be a whisper, a faint and fading image.
Twenty-five years ago, Ronald Reagan was president. Are we lost to our home-grown socialist movement?
If your really want to get into the weeds on healthcare reform myths and the research that shows many proposed “solutions” to be delusions, here is a more in depth essay on why managed care is an illusory thing.
From the Winter 2010 issue of the Journal of the American Association of Physicians and Surgeons.
ObamaCare Policy Myths:Warnings from a 1980s HMO Executive
John Dale Dunn, M.D., J.D.
www.jpands.org/jpands1504.htm
There is a lot of coverage on the news these days about “bullying.”
The epitome of “bullying” will be a government bureaucrat decreeing that you cannot see a doctor or receive medical treatment because he or she says so.
I will always remember a visit to a major HMO’s ER in Sacramento.
I brought a friend there that was suffering abdominal pain that her physician had not yet diagnosed.
The operative term was “suffering”.
She had to wait for over an hour to see a nurse practitioner (2nd hurdle) because the ER was chock full of people that, at worst, looked uncomfortable.
Why were they all there?
They called and that’s where they were told to go.
The only way you cut in line there is to bleed on the receptionist, scream so loudly everyone wants you out of there, or arrive via ambulance.
It was put to a vote as a referendum on whether or not it was imperfect and, if imperfect, therefore bad. Stupid is as stupid does.
Thank you. I’ve never believed the Affordable Care Act was ever about providing health care.