Doctors Can’t Be Trusted About Healthcare

Cancun   Of all of the bad nominations coming our way, the notion of Georgia Congressman Tom Price running the Health and Human Services has the most impact on millions of people because of the impact of his virulent opposition to the Affordable Care Act and the jeopardy it places not only on 30 million beneficiaries there, but also on millions more because of additional threats to Medicare for the elderly and cutbacks in Medicaid for the poor generally. Some hold out a sliver of hope because Price keeps saying that he’s a doctor, and he wants that to mean something along the lines that he cares about peoples’ health. He’s taken the Hippocratic Oath, so he’ll “do no harm.”

James Surowiecki points out in the current New Yorker, that in fact the record of doctors and the American Medical Association has been to oppose virtually every governmental medical program providing health security for Americans for a century now. Doctors organized to oppose universal health care when it came to the ballot in California in 1917 during the First World War, claiming it was a “dangerous device imported from Germany.” The AMA in the 30’s opposed pre-paid medical groups where customers paid a flat fee in exchange for care and was fined for anti-trust violations. The AMA campaigned against the creation of Medicare, and hired Ronald Reagan to go on the air and warn us about so-called “socialized medicine.” The AMA was in the thick of the fight to oppose the Clinton health plan during his first term and only supported Obamacare after the so-called “public option” was off the table.

Ten thousand doctors have already organized in opposition to Price and his plan to scuttle the Affordable Care Act, and though the AMA has endorsed his nomination as a former member of their delegate board and a long-time friend in Congress, there is a schism mounting within the AMA over its stand as harmful to patients. Most hospital associations have been silent over Price’s nomination, but have come out strongly in opposition to the plans to end Obamacare as catastrophic in terms of patient care, hospital closings, job loss, and economic ruin within the healthcare industry. Nurses’ unions have been pretty unanimous in opposing the end of Obamacare.

Price is likely to hide behind the public’s assumption that as a doctor he’s an expert on healthcare. Reading Michael Lewis’ new book, The Undoing Project: A Friendship That Changed Our Minds, might take away any notion that doctors should be seen as our modern day priests. Experiments conducted under the influence of work by Daniel Kahneman and Amos Tversky found that fairly simply algorithms outperformed doctors in making diagnoses of many medical conditions, largely because of the unchecked biases of doctors for the way they are used to seeing and working. That’s scary, but true.

And, as Surowiecki points out repeatedly, the AMA is little more than a very effective special interest group, a closed shop union for doctors, if you will, and their own reports indicate repeatedly that their primary purpose is protecting the income security of doctors. Putting money in doctors’ pockets should never be confused with providing basic healthcare for Americans. We don’t need an algorithm to know the facts about that.


Support for Affordable Care Act Continues to Grow

tumblr_mwbuuuMJib1qg53kdo1_500Little Rock   When a well-known pollster examines the trends and notes that the numbers supporting Obamacare are not only continuing to rise, but are doing so in such a significant way that Republicans are likely to re-message from repeal to reform of the Affordable Care Act, just as soon as they can harvest enough residue opposition as possible for the midterm elections, you know victory is at hand

The governor of Indiana is proposing to move into the expansion ranks with a proposal to extend Medicaid coverage to 350,000 adults there as well, though he wants a pound of flesh in saving face by way of payments from the working poor of up to $25 per month.  HHS says they look forward to the proposal, no doubt understanding that even with a couple of bucks from bleeding the turnip, the savings in life, limb, and hard cash will still be significant even with this poverty tax.   Other states are supposedly debating either the Indiana notion, once it hits the light of day, or the Arkansas private option which involves expansion of Medicaid but is handled by private insurance companies.

Visiting Dallas and Houston recently now that the largely duplicative additional certification for navigators has been completed and the official enrollment period is over, there’s quiet on this front for a change with more focus on Governor Perry’s own legal problems, the upcoming governor’s contest, and even the fact that in anything goes Houston, developers have been fined for harming the property values of neighbor residents from a 21-story apartment tower built next door.  Frankly, they may also be smarting in Texas from the fact that despite all of the hurdles put on the road to enrollment, even Texas exceeded the original Administrative goal for signups.  Ouch, that has to hurt!

A nice breeze is also blowing back in Congress where Republicans were red-faced recently when they invited all of the top health care insurers for what they expected to be an Obamacare hate festival, and found themselves having to manage a whole different meeting as one big insurer after another said how well it was going and how much better they expected that Obamacare and their businesses were going to be because of it.  All of those old lawyers in the House must have forgotten the advice about knowing what the witnesses are going to say before you call them to the bench.   Furthermore, some of the early reports from insurers indicate that any increases in rates for 2015 are going to be mild and in some cases are even going to be lower than the costs for 2014.

For all of the website problems the fact that some states, including Oregon and potentially Massachusetts, are talking about migrating to the federal website because of their own, very expensive problems must be very disconcerting to Obamacare haters as well.  Seems that states aren’t taking too seriously the last-ditch lawsuit about whether the federally administered marketplace would be prevented from offering subsidies.

Never makes sense to run a victory lap until the whole race is over.  George Bush taught us that, but advocates of more comprehensive healthcare can at least breathe more easily now that the wind is to their back, rather than pounding their faces.