nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Wednesday, April 20, 2011

Hannibal Lechter Implements Health Care Reform...The Movie

It's hard to find anything encouraging in health care reform these days.  Most of the process comes out like Silence of the Lambs, Part 2.  (We're the lambs, of course).

As the country's financial situation slides, Standard & Poor's give the government a warning over possible loss of credit rating, and the President gives a passionate speech on his version of deficit reduction that goes over like a soggy French Fry (according to the polls. See here), the citizenry's anxiety level rises.

Meanwhile over at Health and Human Services, they are handing out waivers to the requirements of the health care reform law like lollipops at the doctor's office...and now giving bonuses to Medicare Advantage programs to keep them afloat.  Yes, these are the programs that are so wasteful the PACA phases them out and "saves" hundreds of billions that will be spent to cover the new 32 million covered patients.  This is more of the government's New Math, where we take away with one hand and give it back with the other...and no forward progress is made.

But if you think that's bad, listen to where we're headed.  In Great Britain's National Health Service, the model from which our Medicare director and Administration get their ideas for how national health reform should occur, a recent study by
"The Kings Fund says statistics for February show 15% of patients waited over 18 weeks for treatment, the longest time since April 2008...The official waiting figures are only part of the picture. As the BBC recently found, some parts of the NHS in England have introduced new restrictions on treatment or put routine operations on hold for several months. None of this appears in the [government's] statistics as it occurs before the clock starts." (BBC News Health blog, Apr 19)
What's going on there, and what we risk here, is a focus on social engineering to numeric waiting times.  Prior to this year, Britain's government pushed to track and keep the waiting period low, but found that hospitals were admitting the "quick turn around" cases preferentially to keep their waiting times down.  So this year, the government decided to let up on tasking hospitals to the 18-weeks.  Now the serious cancer cases are getting put in more quickly, but other less lethal, but needed, care goes into the "not-right-now" bin...and waiting times climb.

Either way, the result is pernicious.  The underlying problem is the attempt to cap cost by reducing care.

...Which we are rapidly implementing in the US, through the President's Independent Payment Advisory Board (IPAB), a 15-member, un-elected council appointed by the President who will advise him on policies to keep costs down.  The law forbids the Board from recommending most things.

"Since the board is not allowed by law to restrict treatments, ask seniors to pay more, or raise taxes or the retirement age, it can mean only one thing: arbitrarily paying less for the services seniors receive, via fiat pricing."
For more on the IPAB, see here (WSJ, Apr 20).  I thought we all decided (including most economists) back in the 70's that price controls never work in the long run.
"As a practical matter, the more likely outcome is the political rationing of care for the elderly, as now occurs in Britain, or else the board will drive prices so low that many doctors and hospitals drop out of Medicare. Either alternative would create the kind of two-tier system dividing the poor and affluent that Democrats claim is Mr. Ryan's mortal sin."
The evidence is getting so overwhelming that the government can't make this flawed reform work, that some  analysts supportive of HCR are throwing in the towel, saying, "Yes, rationing will occur, but you'll like it, and it will benefit the country if not you, personally."

As Sheriff Ed Tom Bell says in the movie No Country For Old Men, "If this isn't a mess, it'll do 'til the real mess comes along."

Doc D

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