RSS Feed MenuMickey Kaus directs attention to this piece of interest group payola larded into the House version of the healthcare bill. The bill calls for cultural and linguistic training for healthcare professionals. In making grants for this purpose, the bill says:
The Secretary shall give preference to entities that have a demonstrated record of the following:
(1) Addressing, or partnering with an entity with experience addressing, the cultural and linguistic competency needs of the population to be served through the grant or contract….
The health industry is already a bonanza field for diversity professionals, with results half-comic, half-sinister. The University of Chicago operates a “Center for Latino Mental Health,” based on the proposition that American Hispanics have “unique” mental health needs. Except in the bland sense that all individuals are unique, what does it mean to suggest that one ethnic group is somehow mentally set apart from others?
To write this disturbing industry into the very structure of the complex new health bureaucracy the president and Congress seeks to create – well, maybe that’s not the very worst thing in their plan. But it surely ranks near the top.
liv&win // Aug 5, 2009 at 7:42 pm
Otto: Homogenizing is my term, Obama referred to it when he offered the red pill blue pill. He also referred to it when he suggested that all doctors act a certain way (I think it was the tonsil story).
One size fits all, homogenizing, can help with some, minor health care issues, but when it comes to speciality care, every human is different. Our body chemistry is different and medical solutions don’t fit work for each and every person the same. In truth, a lot of medicine is trial and error to get the right dose and mixture of drugs and other treatments. Hell, you made the same argument.
ottovbvs // Aug 5, 2009 at 8:18 pm
liv&win // Aug 5, 2009 at 7:42 pm
“Otto: Homogenizing is my term, ”
………So he never said it……the red pill/blue pill metaphor was simply a parable to explain we need quantitive analysis of treatment effectiveness……..A good idea I would have thought
“every human is different. Our body chemistry is different and medical solutions don’t fit work for each and every person the same. In truth, a lot of medicine is trial and error to get the right dose and mixture of drugs and other treatments. Hell, you made the same argument.”
………Of course but that doesn’t mean there isn’t a place for analysing outcomes when it comes to treatment…….what are the clinical tests of new drugs but quantitive analysis of their effects ……or that our healthcare system which is a vast patchwork quilt of different administrative systems and procedures wouldn’t benefit from the application of some MacDonalds or Wal-Mart systematization……basically you have an ideological viewpoint and you’re desperately scratching around to find reasonably coherent arguments to bolster it
sinz54 // Aug 6, 2009 at 8:56 am
ottovbvs: I’m always in favor of more standardization. (Where would America be today without time zones and common carriers?)
But on health care, we could have gotten standardization, a mandate on insurers for guaranteed issue, and lots of other good things–WITHOUT the insistence by liberals on a public option whose rates are set so low that the public option can unfairly compete with private insurers and drive them out of the market. (The CBO study didn’t think that would happen, but it assumed a reimbursement rate for the public option that was MUCH higher than what liberals are demanding–that it be set by Medicare rates.)
That has been the only major sticking point.
If there were real constraints on the public option so it can NEVER, EVER lead us to single-payer, I would have found ObamaCare a fairly good plan. Just like I thought RomneyCare had much to recommend it.
The liberals are losing center-rightists like me by their lying and scheming to sneak single-payer past us by stealth.
That point is non-negotiable. If ObamaCare is designed to lead us to single-payer, those of us in the center-right (as well as those on the right) cannot support it.
liv&win // Aug 6, 2009 at 11:53 am
Sinz: from the WSJ editorial pages today:
As for the spending, when has a new entitlement ever come in under budget? True, the 2003 prescription drug benefit has, but those surprise savings derived from the private insurance design and competition that Democrats opposed and now want to kill. The better model for ObamaCare is the original estimate for Medicare spending when it was passed in 1965, and what has happened since.
That year, Congressional actuaries (CBO wasn’t around then) expected Medicare to cost $3.1 billion in 1970. In 1969, that estimate was pushed to $5 billion, and it really came in at $6.8 billion. House Ways and Means analysts estimated in 1967 that Medicare would cost $12 billion in 1990. They were off by a factor of 10—actual spending was $110 billion—even as its benefits coverage failed to keep pace with standards in the private market. Medicare spending in the first nine months of this fiscal year is $314 billion and growing by 10%. Some of this historical error is due to 1970s-era inflation, as well as advancements in care and technology. But Democrats also clearly underestimated—or lowballed—the public’s appetite for “free” health care.
ObamaCare’s deficit hole will eventually have to be filled one way or another—along with Medicare’s unfunded liability of some $37 trillion. That means either reaching ever-deeper into middle-class pockets with taxes, probably with a European-style value-added tax that will depress economic growth. Or with the very restrictions on care and reimbursement that have been imposed on Medicare itself as costs exploded.
On the latter point, the 1965 Medicare statute explicitly stated that “Nothing in this title shall be construed to authorize any Federal official or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided.” Yet now such government management of doctors and hospitals is so pervasive in Medicare that Mr. Obama can casually wonder in a recent interview with Time magazine how anyone could oppose the “benign changes” that he supports, such as “how the delivery system works.”
http://online.wsj.com/article/SB10001424052970203609204574314622075560890.html
sinz54 // Aug 7, 2009 at 12:57 pm
liv&win: I know something about the Medicare situation from first-hand experience.
It’s not that Dems “low-balled” it. It’s that medicine has changed a whole lot since Medicare was enacted, more than 40 years ago.
Back then, most folks with congestive heart failure or kidney failure didn’t have much of a chance of surviving more than a couple of years after diagnosis. So they died, and stopped costing Medicare anything more.
Today, medicine has advanced to the point that it can keep heart patients and kidney patients alive–but at a very high cost. They’re paying $100,000 this past year to keep me alive.
The skyrocketing cost of insurance, both public and private, isn’t really due to waste or low-balling or deliberate fraud. Sure, those things exist in all large organizations–but they’re an overhead charge on top of the actual cost. It’s not like there is ten times more fraud today than there was 40 years ago.
What has happened is that we have entered an age of cost-INEFFECTIVE medicine: Unlike other fields such as computers, advancing technology has RAISED the cost of health care, not lowered it. And that’s because the goal–keeping the patient alive–has no upper bound on cost. We treat each day of a patient’s life as if it’s infinitely precious–and we’ll spend whatever it takes to keep the patient alive, if the patient wants to fight to stay alive.