Thursday, February 25, 2010

Healthapalooza 2010: I know you are, but what am I?

We were out sick today and had hoped to rest and recuperate. Unfortunately, we got caught up watching the President's Healthcare Summit and that pretty much ate up the day. What can we say, we're suckers for political theater. So after meeting and talking for approximately 6 hours today, what did we learn?

It's amazing that anything ever gets done in Washington. However, we thought the President did a strong job of repeatedly pointing out the agreement on all the major issue while framing the big difference between the Democratic bills and Republican ideas is health care coverage for 27 million Americans. It was really just a vehicle for the President to show America that the bills contain major issues that both sides agree on. The Republicans simply oppose the bills on two fronts:

1) On some kind of weak, we-don't-do-comprehensive-well argument, where they want to argue we should just do this a piece at a time because we can't afford this big plan. Hence the retarded references over and over to the size of the bill. Hey, Republicans, we're dealing with the medical field and insurance field. You ever gone in for a simply surgical procedure? get two reams of paper just on your billing and EOBs alone. We actually heard one Republican tell Sheppard Smith it's not fair to expect the American people OR any Senator to really understand a 2700 page bill. This whole idea ignores the fact that you can't do it piecemeal. These issues are so interwoven into the financial structure of healthcare, that you can't do one without the other. You can't take out the prohibitions on pre-existing injuries or the higher rates for women (things Republicans say that agree need to go), without drastically increasing the size of the pool of people covered? Why? Because the way insurance works, is that you have to spread the risk. That means you have to increase the coverage pool to open up coverage in these other issues. This shit ain't simple. It's complex. Try looking at your next hospital bill. Is that crap easy to comprehend? No; and,

2) the very real fact that it is not good for the Republican party for the Democrats to get healthcare reform passed (despite Lamar Alexander's limp-dick comments to the contrary). President Obama made it quite clear in his opening remarks that it was probably in Republicans' political interest to oppose reform. But he said that after pointing out all the issues they agree that need fixing. We don't think Obama is politically naive enough to think these guys are going to cross the aisle because something is "right." This was about showing the country that the plan really is not some crazy ass liberal socialist takeover and providing some political cover for Democrats to go ahead and push it through. If he wins a vote or two over, that's just gravy.

We thought the most telling exchange was between the President and Sen. Jon Barrasso (R-WY). We find it telling, because it highlights the fundamental flaw with the GOP's approach to health care.

"Would you be satisfied if every member of Congress just had catastrophic care--you think we'd be better health care purchasers?" Obama asked Barrasso. "I mean, is that a change you think we should make?"

"I think actually we would," Barrasso responded. "We'd really focus on it. We'd have more, as you say, skin in the game. And especially if they had a savings account--a health savings account--they could put their money into that, and they'd be spending the money out of that."

"Would you feel the same way if you were making $40,000. Or if that was your income. Because that's the reality for a lot of folks," Obama said

The GOP seems to be find with health care insurance being treated the same as automobile insurance. You know...the same industry that has carriers who advertise that they "get you legal for less." Anyone that has ever been involved in a motor vehicle accident and been unfortunate enough to have to pursue underinsured coverage from their own carrier know just how terrible relying on your insurance carrier to do the right thing can be (especially if your carrier is Allstate).

Some additional thoughts from today, along with some comments we had during the summit:

-Trial lawyers and frivolous lawsuits are why your healthcare costs are so expensive. Uh...that's just dumb. The problem is not med mal lawsuits, the problem is an increase in med mal injuries. Listen, this isn't us just pulling shit out of our ass. These are facts. In a Harvard study released TWO decades ago, they showed that doctors were injuring 1 out of 25 patients, but only 4% of those injured patients ever sued. Another later Harvard study showed that 90% of medmal cases studied showed evidence of medical injury, ie., they weren't frivolous. That same study showed the majority of frivolous lawsuits were thrown out. The truth is, med mal cases are expensive to bring. It makes no sense for any atty to bring a BS med mal case. They'll wind up losing money.

This myth that defensive medicine is borne from lawsuits is BS. The use of all these "unnecessary" test have skyrocketed at the same time that jury awards and suits have stayed at basically the same levels, while actual INJURIES have increased. The reality is that at the end of the day, the insurance industry benefits from all these unnecessary tests. The more expensive healthcare is, the more necessary health insurance is, thus the more health insurance providers can charge.

If you want to actually curb costs related to medical injuries, you have to fix the actual problem: the medical malpractice itself. Studies have shown medical professions (like anesthesiologists) or particular hospitals that actually look at the claims against them, then use that info to correct bad practices, have been able to reduce the actual claims against them and in turn reduce their rates.

But at the end of the day, it's easier to blame the lawyers than actually your own problems.

-John McCain is still a bitter, petty, small man.
Okay...this was common knowledge before McCain's campaign against Obama, but was highlighted during that campaign. But McCain being McCain, he can't let that hatred go. There was a sure-to-be-replayed-over-&-over exchange between the President and McCain today. McCain wanted to bitch and whine about "broken campaign" promises (something he's had his panties in a wad about ever since he said Obama went back on his word about having joint town hall meetings). The President cut him off and reminded McCain that the campaign was over. Obama remarked that "we can have a debate about process" or about how to agree and pass health care reform. "The latter debate is the one [the American people] care about more."

Later, Kelly O'Donnell said on MSNBC that McCain's staffers were very upset. Apparently, McCain's "job" at the summit had been to attack the "process" by which the Democratic bills were made, because McCain is suffering a very serious challenge at home and he needed to score some points with voters in Arizona. That's just a fine example of Mr. Country First, is it not? Americans need & want health care reform? Well...I need to get my soundbites for my reelection, Mr. President, so let me get off topic.

-Republicans new catchword is "Reconciliation." Why?
McCain later came after President Obama about reconciliation, saying Obama had opposed reconciliation back during Bush about the judges. First off, McCain completely mischaracterized history. The Republican majority at the time was not trying to get judicial appointments through via reconciliation. Instead, they were threatening to change the rules of the Senate to do away with the filibuster. Shit...we wish they would have. But be that as it may, the harping on reconciliation is a tactic to try to convince the public that the Democrats are pulling some underhanded tricks to pass this bill. That's complete horseshit. Reconciliation was made for exactly this. You've got two bills. Reconciliation allows you to do just that, take two bills that have been passed and reconcile their differences. BTW, its a process we've had to use to pass all kinds of healthcare stuff (COBRA, CHIPs, Emergency Family Medical Act, etc). Why? Because the healthcare/insurance lobby is so strong you have to use reconciliation to get anything passed in those fields. Another BTW is that the GOP has used reconciliation the most over the passed twenty years including the Bush Tax Cuts.

-If Republicans were comedians, they'd be Carrot Top.
This isn't a knock on John Boehner's love of bronzer. Rather, it's an indictment of his and Eric Cantor's see-through attempts to use the actual bill itself as a prop. Cantor was first and it was pretty clear what the President thought of it. He pointed out the use of props is the kind of political gamesmanship that would not serve anyone there. We particularly loved how Cantor had his open to certain pages, like he was actually going through it and reading stuff during the summit. Whatever. Same with the very-bronzed John Boehner. Boehner made sure we all saw his tabbed, highlighted copy.

-Republicans are for state's rights! Except when they are not.
The President pointed this out to them at the end. You guys want to take up the banner of letting states decide some issues and not others. Hey...why not take that approach to gay marriage? Because it is not politically convenient.

-Republicans forget that the Presidency is an equal branch of government.
This was actually brought up during the event by Boehner and has been a favorite topic of the spinsters after the fact. But as of 3:02, the time breakdown was this: Republicans = 56 mins; Democrats = 50 mins; POTUS = 57 mins. As Obama reminded them, hey...I'm the President. This brings up an important notion. Say whatever you will about the uselessness of this event, but it was nice to see a CINC who was knowledgeable and engaged enough to not only call this summit, but to basically moderate it and have a strong enough grasp of the issues that he had no problem diving into the depths of nuance and policy as it came up.

Anyway...some quick thoughts we had during the day as this circus was going on:

-Note to GOP: if you're concerned about the "optics" of President Obama coming off as "in command" maybe you should have won that election.
-someone should tell Lamar Alexander that having a tkt to a bus that only runs half the time is better than never having a ride at all.
-hey Lamar, reconciliation is not a little used process: it's how we got COBRA, CHIP and the Emergency Medical Treatment act. So eff off
-Benen sums up GOP opening by Lamar Alexander: 17 minutes of "NO" w/ a bizarre metaphor about a car show & an Alexis de Tocqueville quote.
-is Max Baucus trying to sound like Wayne and Garth pretending the drive-thru speaker is broke? If so, that's a damn good impersonation.
-Therein lies the rub. GOP thinks Safe Auto-like "legal for less" health insurance is ok. That's great until you actually get rear-ended.
-American families have not rejected the current HC bills. When informed about what is really in bills, not rhetoric, the majority approves.
-So, McCain whines about the campaign. Shocker. Enjoyed Obama's Andrew Sheppard-to-Bob Runson bitchslap: Your 15 mins are up, John
-says Megan Kelly, let me answer that for you: You're damn right the President will sign a bill that comes to him through reconciliation.
-Dear Andrea Mitchell: Rank has its privileges. It's why Barry gets to call him John & John has to call him Mr. President. aka scoreboard
-is impressed with Tyra's producers. On the same day as Healthapalooza, Tyra has a show devoted to freakish medical conditions. You go girl
-thinks that most Americans don't reject reconciliation. In fact, I suspect most can't understand why 51 votes IS NOT ENOUGH in the Senate.
-agrees w/ Atrios: if they really care @ GOP votes, why not threaten to put in all kinds of crazy liberal hippie shit through reconciliation?
-is wondering if the Dems include coverage for bronzer and hair dye, what are the odds Boehner and Cantor swing their vote?

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