RSS Feed Menu
Rand Paul’s libertarianism stops where his pocketbook starts, or so reports the Wall Street Journal today:
Tea party favorite Rand Paul has rocketed to the lead ahead of Tuesday’s Republican Senate primary here on a resolute pledge to balance the federal budget and slash the size of government.
But on Thursday evening, the ophthalmologist from Bowling Green said there was one thing he would not cut: Medicare physician payments.
In fact, Paul — who says 50% of his patients are on Medicare — wants to end cuts to physician payments under a program now in place called the sustained growth rate, or SGR. “Physicians should be allowed to make a comfortable living.
I guess this is what the original Rand meant by the morality of selfishness.
Cute, even though I’m not a fan of the SGR either.
What I like is that whenever Ron Paul is inconsistent, his fans say, “well he’s a politician, etc.” but whenever I support other politicians, they say “well that just shows you’re no small-government conservative, etc.”
Answering Chait | FrumForum // May 14, 2010 at 3:39 pm
[...] “small government for everybody except me personally” approach to politics (see below) presents a target-rich [...]
Nobody is perfect. He’s still a hell of a lot better than that tool he’s running against.
If you cut payments to Doctors they’ll stop seeing Medicare patients. There’s very little money in seeing them right now. They’ll start losing money. But that’s what Obama and company want.
JimBob // May 14, 2010 at 4:30 pm
“If you cut payments to Doctors they’ll stop seeing Medicare patients. There’s very little money in seeing them right now. They’ll start losing money. But that’s what Obama and company want.”
……still in myth land I see Jimbo…..Medicare payments represent about 25% of ALL payments for medical products and services in the US……Do you know how much that is (around $500 billion)…….So a hell of a lot of doctors are accepting them
You’re a buffoon otto.
http://www.theepochtimes.com/n2/content/view/30562/
JimBob // May 14, 2010 at 9:52 pm
“You’re a buffoon otto.’
……the ad hom……the sure sign you’ve lost the argument Jimbo…….I didn’t say they were happy with their remuneration (who is) but Medicare payments are a major part of doctor’s revenue stream
Doctors don’t make much money seeing Medicare patients right now. Cut the payments more and all Doctors will drop them. That’s what Obama wants.
The Blog post is just Frum taking a cheap shot.
JimBob – Don’t cut doctor payments and your taxes will go up. A lot. What’s your alternative?
Adude, there are two options. Start rationing care to Seniors or market based means tested vouchers. I know the media had a fit when Palin talked about death panels but if we continue down Obama’s path that’s where we’re heading for. Or we give Seniors a voucher and let them go out in the Market and buy what insurance they want. Rich Seniors would be on their own. Lots of creative things could be done. Liberate Doctors and turn them into entrepreneurs. Same with Registered Nurses. The welfare state is going to bankrupt the country. Economic realities will set in once 75 million boomers start retiring in large numbers.
Tell Granny to drop dead or let the market solve the problem.
Tell Granny to drop dead or let the market solve the problem.
LOL!
And there you have it: a neon marker of the GOP’s self-inflicted, grisly state of irrelevance.
JimBob: I’m sure you’ll forgive me if I don’t relay your message to my kids’ 70+yo grandparents; my Ps are understandably not as confident as you in an unfettered market’s ability to magically resolve serious socio-economic challenges. Particularly this one.
ward, Medicare has a 38 trillin dollar unfunded liability . Medicare is a government run program. We are going bankrupt because of government promises it can’t keep. Europe is going bankrupt because of government. And all some clown like you can do is LOL. . You’re not serious person.
JimBob.
Sigh. Aside from the crassness of your comment, you really don’t get how laughable, in its absurdity, your simplistic position is. I do understand the seduction of bumper-sticker solutions, but many like yourself confuse that easy seduction with self-evident legitimacy.
Here.
Just for kicks, read this:
http://www.imaginewhatif.com/2009/11/why-free-market-competition-fails-in-health-care.html#more
…[I]t is vastly more complex to structure a health care market rationally, in a way that delivers real value, than it is to structure any other sector, and simply fostering “free market” competition will not solve the problem.
Come back with a reasoned argument, and perhaps I’ll take you seriously.
Joe Flower is a big proponent of a single payer system. In other words, rationing of health care. I rest my case.
What case?
Our health care has always been rationed for everyone but the wealthy, and our seniors on Medicare.
Healthcare Insurers have long engaged in all kinds of rationing: denying coverage due to pre-existing conditions, rescission, limited or no benefits for out-of-network care, prohibitive premiums for individual insureds, denying coverage for certain costly procedures and treatments.
I suspect you’re not all that interested in the HC rationing experienced by the working poor and the destitute.
All that rationing by faceless administrators with one primary concern: their company’s bottom line.
Single payer is the epitome of rationing. Shortages long waits for treatment. There is an industry in Canada helping people come here to get private coverage. Medical breakthroughs depend on profit. Without large profits we might not have the miracle drugs. Profits save lives.
http://www.youtube.com/watch?v=l9u2UU6-wlk
ottovbs: Medicare payments represent about 25% of ALL payments for medical products and services in the US
Here in Massachusetts where I live, a dialysis clinic just 10 miles from me shut down because they couldn’t remain solvent with the low reimbursement rates they were getting from Medicare. (Most of their patients only had Medicare, not private insurance.) So most of those patients ended up being shoveled into my clinic, where they cost-shift the difference onto higher bills for those patients with private insurance, like myself.
At my dialysis clinic, all the talk from the nephrologists and the nurses is how low Medicare reimbursement rates aren’t keeping up with the rising cost of treating us patients.
A crunch time is soon coming when the soaring number of dialysis patients (now 200,000 and climbing) will no longer be able to be treated, unless Medicare reimbursement rates are adjusted upward.
Don’t take my word for it.
Go telephone the nearest dialysis clinic in YOUR area and ask THEM about this.
ottovbs:
One more thing. To cope with soaring costs, Medicare is likely to introduce “bundling”–another term for capitation–starting next year. What that means is that nephrologists and dialysis clinics will now have a fixed umbrella budget from Medicare. The more they spend on one patient, the less they will have to spend on another. (You may recall that when HMOs tried capitation in the 1990s, there was such a backlash by the patients that the HMOs abandoned it.)
The implication of this, that my physicians have told me, is that nephrologists will have to restrict their practice solely to treating kidney disease.
The way dialysis works is that the nephrologists stop by the clinics regularly to see how the patients are doing.
Up till now, if one of their patients had a serious lung infection or skin infection, they would treat that and bill Medicare for it. Now that will have to stop. The patient will have to see a different physician for those things, which is difficult for patients who are disabled or in nursing homes.
The American Spectator : AmSpecBlog : Rand Paul and Medicare Physician Payments // May 17, 2010 at 12:37 pm
[...] Frum hits Rand Paul for opposing cuts to Medicare physician payments, based on a short item in the Wall [...]
Wonk Room » Rand Paul Supports Doc Bail-Out: ‘Physicians Should Be Allowed To Make A Comfortable Living’ // May 20, 2010 at 11:52 am
[...] Paul’s sentiment is shared by the American Medical Association and other doctor’s groups, but it’s particularly surprising for a candidate who rallies against “out of control” government spending and warns that the country could experience a Greek-like debt crisis. “I’m concerned that we could have a debt crisis in this country, and we’ve got to look at the entire budget,” Paul told CNN’s John King. “We either downsize departments, maybe eliminate some departments, maybe privatize some departments, or maybe we can’t do anything to a department. But we look at every department, every expenditure, and we find out how it can be reduced.” Apparently, the same does not apply for his own pocketbook. [...]
As a former Medicare Part B supervisor of Medical Review, it can be stated without a doubt, opthalmologists were the biggest abusers of the Medicare program. The worst set up factories in which their offices were large horseshoes. They would have patients all lined up and perform cataract surgeries as fast as they possibly could (15 minutes a pop) charging the program four figures for each one. Further, the best had a motivation not to do a very good job of the initial surgery, so that they could have the patient come back and use a laser gizmo that would clear scar tissue and debris from the eye from having done a poor/fast job. At that time, they could bill extra for this service (motivation to do a poor job?). For some reason, the biggest recipients of reimbursement for these services used both procedures the most. Has anyone done a FOIA request for Mr. Paul’s reimbursements from Medicare on a semi-annual basis? I am guessing he is one of the many opthalmologists who have helped themselves at the cataract trough. He is quite wealthy, is he not? How many people who have cataracts aren’t on Medicare?
Rand Paul opposes government spending — except for when it benefits him. | No Bull. news service. // May 20, 2010 at 3:14 pm
[...] Republican Senate primary by running on a “resolute pledge to balance the federal budget and slash the size of government.” In an interview following his win, Paul explained that his campaign was “all about [...]
The Politics of an Aging Population // May 23, 2010 at 10:15 pm
[...] Even Senate hopeful Rand Paul, darling of the tea party crowd and self-described libertarian, favors a big increase in payments to doctors who treat Medicare [...]
BEEZERNOTES » Blog Archive » The Right’s Big, Big And Growing Political Problem. // May 24, 2010 at 4:00 pm
[...] Even Senate hopeful Rand Paul, darling of the tea party crowd and self-described libertarian, favors a big increase in payments to doctors who treat Medicare [...]
Repugs Attempt to Salvage the Rand Paul Brand | Republican Dirty Tricks // May 25, 2010 at 11:48 pm
[...] who consistently display symptoms of classic malignant narcissism, his libertarianism stops where his pocketbook starts.” Former Bush speech writer David Frum noted in a Wall Street Journal story from last week in [...]
JimBob writes:
“Joe Flower is a big proponent of a single payer system. In other words, rationing of health care. I rest my case. … Single payer is the epitome of rationing.”
As ktward says, “What case?” Medicare is “single payer.” Is Medicare “rationed?”
When it was a live political question whether the U.S. should move to a single payer healthcare system, my answer was, “Yes.” But that particular argument has been over for a year, and “yes to single payer” never was any kind of final answer – because any system can be made to work better than ours. There is no healthcare economy around the world that pays anywhere near as much as we do. Everyone else pays roughly half or less of what we do, and most get better outcomes than we do. You pay more for less, you’re the chump. When it comes to buying healthcare, that’s us.
Any economic system has to provide some way to choose value. Simple “competition” between providers in healthcare does not do it, because the competition takes the form of providing more and more services without any way for the buyers to tell what is “worth it,” what is necessary, what makes a difference. The evidence is simple: Medicare data show that some places cost three times as much per year per capita, with outcomes that are the same (or even negative, for some diagnoses) in the more expensive places. Compare the high-spending places (such as Dallas, Miami, Los Angeles, and New York) to the low-spending places (like Oregon, Washington, Utah, Minnesota, Wisconsin, Temple TX, Sacramento CA) and what you don’t find is any broad, consistent pattern of differences in socioeconomic level, or ethnic diversity, or age demographic. What you notice is that all the really expensive areas are extremely competitive provider markets, and the less spendy places are more cooperatively organized in a number of different fashions.
And it’s not about quality. The two least expensive medical systems in which to spend the last two years, year, six months of your life are the Mayo Clinic in Rochester, Minnesota, and the Cleveland Clinic.
Healthcare economics is hard. You have to pay attention. You have to watch the hand with the coin in it. Simple bumper-sticker slogans will never get us where we want to go. Where we want to go is to stop being the chump.
FreakOutNation » Tea Party Socialism And The Not So Fiscally Conservatives // Sep 30, 2010 at 9:38 pm
[...] libertarianism stops where his pocketbook starts.” Frum highlighted a Wall Street Journal story from last week in which Paul said he doesn’t [...]