Obama opens mouth, inserts foot: on diabetic amputations and preventative medicine
By now you’ve probably seen or read a transcript of this excerpt from Obama’s healthcare talk in Portsmouth NH:
The American College of Surgeons has come back with a critique and correction that points out that a surgeon actually gets only between $740 and $1,140 for a leg amputation rather than the $30,000 to $50,000 stated by our non-detail-oriented President: “This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation.”
No surgeon is going to get rich doing that sort of thing. And in fact, if you actually think about it, Obama’s assertion that preventive care for diabetes—involving helping a patient “lose weight, modify diet, [monitor] whether they’re taking their medication in a timely fashion”—reimburses at “a pittance” doesn’t seem to be true either. Last time I checked, doctor visits are rather expensive, and frequent ones do add up, reaching fees equal to that surgeon’s reimbursement rather quickly.
Most people who’ve written negatively about the Obama amputation quote have focused on the fact that he’s insinuating (although not quite saying outright, as he did earlier about tonsillectomies) that doctors seek out such amputations and perform them unnecessarily in order to get the extra money. They also assert that, as the ACS says about Obama’s tonsillectomy claim, “That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient.”
But in thinking about Obama and the amputation remarks, there’s a great deal more that’s troubling in what he said. His statement was part of a tendency of his to speak out authoritatively on matters about which he knows nothing or almost nothing.
One of the most off-putting things about Obama is his arrogance. And it’s not just a personal arrogance, it’s an intellectual arrogance as well. The most dangerous ignorance is the ignorance of a person who doesn’t know what he/she doesn’t know. And it’s even more dangerous when someone who fits that description—Barack Obama—is in a position of great power and filled with the righteousness of his cause, as well as the ruthlessness of the true believer.
So let’s not be arrogant or ignorant ourselves, and let’s read about diabetic amputations and how to prevent them (see also this). I think you’ll observe, as I did, that it’s a very complex subject to which doctors have devoted a great deal of thought and attention. In essence, much of the prevention involved (as is true with nearly all of diabetes care and treatment) depends on the patient him/herself taking charge of his/her own self.
Diabetics, even if they strictly follow all the difficult behavioral rules that go with their sometimes cruel disease, often have problems with neuropathy in the extremities such as the feet, as well as poor circulation. The net effect is that they are subject to having serious infections from even minor wounds and abrasions that in a non-diabetic would tend to heal quite easily. The key for many diabetics is to follow a regimen of inspecting their feet every day, taking immediate steps when they find a problem, reporting all abrasions that fail to heal in a timely fashion, and going for medical help when needed.
No amount of increased reimbursement for preventive care is going to significantly change the fact that the management of diabetes is up to the patient as the first and most important line of defense. Non-surgeons who treat diabetics are dedicated to helping them do this, but there is no way to compel a non-compliant patient, since we haven’t reached that level of police state yet (and please see this for a description of the exceptionally thorough and very impressive job that is currently done by physicians working with private health insurers on the matter of the medical care of diabetes).
So, what did Obama actually mean by his ignorant and somewhat cryptic statement? Surely there was a grain of coherent thought there. My guess is that part of what he meant to say is that preventing diabetes, and/or controlling it as well as possible, would be preferable to doing a lot of amputations. That’s a rather noncontroversial statement on which I think we can all agree.
Unfortunately, we have no more effective ways of doing so than are already in place, because it involves patient lifestyle choices that we cannot control through medicine (even preventative care), such as making large numbers of people lose weight and keep it off. Medicine has virtually no idea how to do this, any more than it can make people exercise more (which would probably help as all).
If Obama was attempting to talk about facilitating better control of diabetes in terms of blood sugar levels, this is already done as best as medicine can currently accomplish it. And once again it depends on patients taking charge of their own lives and health habits, and compliance with things like glucose monitoring and diet.
Quitting smoking is another thing that would help mightily. If you read the links on diabetic amputations you’ll see that smoking is a huge risk factor and implicated in many of the amputations. But surely President Obama, of all people, is well aware as a smoker of how difficult that task is, even with the best of medical care. He hasn’t quite been able to do it himself yet.
If Obama was meaning to say that he favors extending good non-emergency medical care to more of the diabetics and pre-diabetics who are currently uninsured, that’s certainly a laudable goal. I believe that was another part of his intended message. But it has nothing to do with the differential between reimbursement for this type of care (which is certainly not a “pittance”) versus the reimbursement for surgeons for an amputation (which is certainly not exorbitant). Doctors who treat diabetes are already fully dedicated to preventing amputation surgery, and his insinuation that the relative amounts of reimbursement for prevention vs. amputation have anything to do with how diabetes is actually treated in this country is another example of his now customary slander against the medical profession.
The fact is that we are already “reimbursing the care that prevents the amputation,” except for many of those who are uninsured. If Obama wants to extend that same preventive care to the now-uninsured by insuring them (as I definitely believe he does), that’s fine. Just say so clearly, and don’t slander doctors when you do it.
And don’t pretend it will cost less, either—it will cost more. That’s just common sense. Whether it’s worth that increased cost is a separate issue, one of the cost-effectiveness of preventive medicine, a complex matter which Charles Krauthammer (doctor Krauthammer to you, President Obama) tackles in this excellent piece.
It’s clear that Obama’s statement about diabetic care is riddled with difficulties, some of them obvious and some of them only emerging after deeper reflection. Are Obama’s critical thinking skills really that poor? Is his judgment that bad? Is his grasp of these really rather elementary concepts that weak? Or is it that he just cannot stop lying to the American people in order to attempt to reach his health care reform goals?
[ADDENDUM: I wanted to add some further thoughts from commenter “E,” who has Type 1 diabetes:
But if [Obama] is so concerned about preventive care, then why does Medicare only authorize reimbursement for 100 test strips for three months for Type II patients, and 100 test strips for one month for insulin dependent patients like me? That’s three strips a day – when (on a good day) I routinely use 6-8 to monitor my daily blood glucose ups and downs.]
[ADDENDUM II: Commenter “MrsWhatsit” has a suggestion worth pondering:
How about if we cancel the [unspent stimulus bill] pork and use that money, instead, to subsidize insurance coverage for those who can’t afford it, right now? It would pump a lot of money into the economy through the health care gateway and, perhaps, actually help to get things back on track the way we were told the stimulus would back in January. It would temporarily, solve the problem of getting people insured without driving up the deficit any more than the ungodly amount that we have already had imposed upon us. And it would give us time to have a serious, deliberate, patient conversation, without lies, scams and hysteria, about how we are going to increase access to health care for all Americans without bending that cost curve in the wrong direction.]
With so much of that the money goes a number of places. It would be interesting to see what the average doctor actually pockets out of payment for an office visit.
I heard an interesting anecdote (supposedly only second hand) about a guy who had a surgery and got hit for thousands of dollars for an “out of network” doctor. His entire hospital, surgical staff, and surgeon specialist were absolutely “in network” and he couldn’t figure out how his insurance managed to screw up so badly.
It turned out that regulations required a *second surgeon* to be on call during his entire surgery in case his doctor dropped dead in the middle of it and the only other available surgeon with the same specialty was out of network.
This had to have been a policy of the Hospital to be certain it was covered in the extremely unlikely possibility that a surgeon doing surgery couldn’t continue and they got sued.
How often does something like that happen?
Is it reasonable to make patients pay for two surgeons or is this just financial CYA?
Awesome narrative about this arrogant and spiteful man. Knocking Obonga (thx Fred) on smoking was sooooo right.
It’s extremely difficult to learn anything new if you’re convinced that you already know everything.
I think Obama has been overexposed to the academic theory that all aspects of human life are basically about power relationships. Hence, it is unneccessary to actually know anything substantive about medicine, or energy, or history, or anything else…you can understand it all with your metatheory.
Quite analogous to a certain kind of MBA, who believes that—because he knows how to do a discounted cash flow analysis and sketch out a BCG 4-box matrix—he doesn’t need to know anything sustantive about the business he is supposed to be helping to run.
Let me be the first, and probably only correspondent to offer these obvious puns. Because they are slow moving targets, my favorite kind. Just like most liberals.
Looks like this plan doesn’t have a leg to stand on.
You’ve got to hand it to Obama.
Obamacare could cost an arm and a leg.
Like I said, easy target.
Well, you be the judge. Because he even even calls his grandmother into service and misrepresents her problems to a purpose. Recall the infamous issue of the poor woman’s hip replacement, for which the medical establishment was oh-so-gently castigated, since it occurred, we were told, in the late stages of her terminal cancer, and she might better have been served without it? He glosses the details easily, most times, when he speaks about it, leaving the staring impression that a dying woman underwent a difficult and taxing procedure for no particular reason or real benefit. Except…except–the facts are these: his mother, indeed suffering with terminal cancer, fell and broke her hip. I am a medic. I’ve been around broken bones, including broken hips in the elderly. Even without knowing the nature of the break, I CAN say that it is agonizing to move with a broken hip — but if you don’t, or you can’t, a patient will shortly develop pressure sores and these can and will progress to gangrene and death. Surgical repair of the break may indeed have required replacement of the joint, although I suspect it was rather less drastic, centering on stabilizing the bone for healing, rather than restoring a joint for future weightbearing ambulation, but for certain there is almost no way to fix an elderly patient’s broken hip without surgery. So Obama is fostering the impression that an essentially unnecessary hip replacement surgery (THA) was done on his grandmother, when in fact some kind of repair surgery was absolutely unavoidable; she could not have been moved or turned in her bed without it. He has repeatedly palmed the performance of this surgery off as a “quality of life” question for some kind of panel, but it was nothing like that — it was, in fact, an issue of life or death. So. What does his use of these facts say?
Will Rogers said it well — ““It’s not what we don’t know that gives us trouble. It’s what we know that just ain’t so.”
Of course, if Obama unlearned everything he “knows” that ain’t so, he’d be completely ignorant.
I think we are now watching Obama skid through the generous suspension of disbelief to the realization that Obama is just making stuff up.
I can remember wincing at Bush’s malapropisms, grammar malfunctions and his aw-shucksisms but never this kind of “I know it all; let me explain it you” idiocy.
Obama doesn’t know quite a lot. Worse yet — with a nod to Donald Rumsfeld — Obama doesn’t know what he doesn’t know.
I do wonder how many of the greedy, over-paid doctors got a quarter-mil yearly raise for doing the same job?
A staple of the old Commie art was variations on the theme of Wise Leader instructing an admiring crowd in its professional specialty. Teaching brain surgeons how to cut….engineers how to build a dam….rocket scientists how to design the engine….pilots how to fly…actors how to act….and so on and so on. In this context, I think we’re all being a little hard on Obama’s little faux pas.
I had a thought today that I don’t believe I’ve heard anyone else articulate. Let’s assume that most people want to do something to help those who are uninsured obtain coverage. I believe the polls support that. Let’s also assume that most people don’t want to rack the deficit up any higher than it already is or pay higher taxes themselves to accomplish this. I think the polls support that, too. Now. Remember the stimulus? All those gazillions of dollars that had to be spent Right Now to save us from financial perdition — but were generally earmarked for Congressional pork and mostly haven’t been spent yet? How about if we cancel the pork and use that money, instead, to subsidize insurance coverage for those who can’t afford it, right now? It would pump a lot of money into the economy through the health care gateway and, perhaps, actually help to get things back on track the way we were told the stimulus would back in January. It would temporarily, solve the problem of getting people insured without driving up the deficit any more than the ungodly amount that we have already had imposed upon us. And it would give us time to have a serious, deliberate, patient conversation, without lies, scams and hysteria, about how we are going to increase access to health care for all Americans without bending that cost curve in the wrong direction.
Most likely this is a bad idea, and I’m sure someone will explain why shortly. But if we’ve got to spend this money on something, wouldn’t it be better to spend it on this than on pet projects for legislators who can’t even be bothered to read bills or talk to their constituents?
His statement was part of a tendency of his to speak out authoritatively on matters about which he knows nothing or almost nothing. One of the most off-putting things about Obama is his arrogance. And it’s not just a personal arrogance, it’s an intellectual arrogance as well. The most dangerous ignorance is the ignorance of a person who doesn’t know what he/she doesn’t know.
Bingo, Neo. Here is an example of that arrogant ignorance from last year: his inflating tires claim.Here is what ∅bama said, without assistance of a teleprompter:
Putting the numbers to ∅bama’s claim, we get:
What was even more annoying about this was that ∅bama would not admit he was wrong. Seven will get you eleven he will follow a similar tack with his “medical claims.” ( Sorry, couldn’t resist the pun.)
Neo, I think you have confused the AMA with the ACS (American College of Surgeons) as the source of the critique. (No intention to nitpick– just to give credit where it’s due).
Thanks for another fine post.
# Synova Says:
“Is it reasonable to make patients pay for two surgeons or is this just financial CYA?”
A: I don’t buy it because most insurance pays by line item. As in, if everyone else was in network, they’d have paid all that was. I’ve had three page hospital bills where everything but one line item was paid (and then I had it cleared up by having it rebilled with different billing codes from the hospital) / ie, one bad item doesn’t negate the whole bill.
B: If were true, its also true that insurance companies are already regulated by the states. You can write to your state insurance regulator and have them look into it free of charge.
Neo, thank you for taking Obama’s diabetic amputation argument apart so thoroughly – one might almost say surgically.
I’ve had Type I diabetes for 34 years, and I was deeply offended by Obama’s comments. What an ignorant, stupid, manipulative thing to say about diabetics and their health care providers.
This is not an easy disease to live with, even if you’re well educated and motivated and blessed with otherwise good health. You have to work closely with your doctor and care team to manage the condition. Nurse practitioners, endocrinologists, primary care doctors, and nutritionists spend all their time helping people with diabetes live better lives and avoid long-term complications. The suggestion that doctors connive to withhold information about preventative care so that surgeons can rack up amputation fees makes me really angry.
Obama used the diabetic amputation story as a scare tactic – because the incidence of Type II diabetes is rising in this country, and nearly every one of us is close to or knows someone who’s struggling with the disease. (Only about 10% of the diabetic population has Type I, or insulin-dependent diabetes, which is not caused by lifestyle choices. It’s an auto-immune disease which occurs when the body’s immune system kills off insulin-producing cells in the pancreas, creating the need for life-long injections of insulin. My current regimen calls for 5-6 injections daily.) But if he is so concerned about preventive care, then why does Medicare only authorize reimbursement for 100 test strips for three months for Type II patients, and 100 test strips for one month for insulin dependent patients like me? That’s three strips a day – when (on a good day) I routinely use 6-8 to monitor my daily blood glucose ups and downs.
Under a government plan, my ability to manage my disease and avoid long-term complications would be severely curtailed. My health would suffer. I was against Obama care from the start, because on principle I don’t like the government’s intrusion into this area of our daily lives.
Now, it’s personal.
“And don’t pretend it will cost less, either–it will cost more. That’s just common sense. Whether it’s worth that increased cost is a separate issue, one of the cost-effectiveness of preventive medicine, a complex matter which Charles Krauthammer (doctor Krauthammer to you, President Obama) tackles in this excellent piece.”
Yeah, there has been a trend to hire RNs to man phones (who make 70k+ a year) to nag people to manage their chronic conditions. It can only ‘save’ money with certain groups (elderly, who forget to do their routines at higher than normal rates) with certain conditions (like heart failure, because it won’t kill you to fail to do your routine, so you can keep ending up in the hospital over and over for making the same mistakes).
With other groups, it might improve quality of life but I doubt it would save money… with those RN salaries, it will cost money.
Whateva..neo
The increasing rate of diabetes diagnoses in the United States is cause for alarm. Related healthcare costs are staggering, as data shows the total annual cost of diabetes treatment in 2002 (including direct and indirect costs) was estimated at $132 billion, or one out of every 10 healthcare dollars spent in the United States. 1 Other studies have suggested that diabetes-related amputations cost approximately three billion dollars per year ($38,077 per amputation procedure). 2 With the rise of diabetes diagnoses, there is also an expected rise in the number of amputees.
http://www.amputee-coalition.org/fact_sheets/index.html#topic3
Here’s the specific link, same site
http://www.amputee-coalition.org/fact_sheets/diabetes_leamp.html
Yes, logern, that’s the total cost of the procedure, involving the hospital, the anesthetic, all of that. If you listen to Obama, however, he speaks of the surgeon as getting the specified fee “immediately.” It’s the surgeon who makes the decision, and health insurance (or Medicare) approves or disapproves—the rest of the costs are not costs the surgeon reaps the benefit of. Obama is clearly implying otherwise, although he doesn’t actually say it straight out (he did say it straight out with the issue of tonsillectomies, another issue on which his facts were incorrect).
If you actually bothered to read what I wrote, I was very careful to agree that preventing amputations would be a good goal. But it is the goal of medicine as practiced now, and Obama’s remarks were highly misleading as well as incorrect about the surgeon’s fee, as well as the way medicine and diabetic treatment and preventative care works.
You reply with your usual sophistry and inattention to detail. Read my post and try to use logic and reading comprehension to actually follow it.
PA Cat: thanks. I’ll fix it.
Why, oh why, are we surprised, nay shocked, at the Big Lies of Obonga and the Big Dems of the Congress?
Bottom Line: if he says it, it’s not true.
I think your idea is a great one, Mrs Whatsit. I estimated we could cover the uninsured with excellent insurance for a worst case cost of $166.6 billion per year. If we figure that 75% of the $700 Billion stimulus is unspent that leaves us $525 Billion for the uninsured. That should pay for just over 3 years worth of coverage. This would, indeed, take care of the pressing problem of the uninsured while giving us time to carefully consider whether we even need a more sweeping reform and, if so, what it should look like.
Well, there you go again trying to make sense of what he’s saying.
Thalpy: yes, it’s a tough job, but somebody’s got to do it. Obama certainly isn’t.
So, what did Obama actually mean by his ignorant and somewhat cryptic statement?
He means nothing, but purpose to move material. In this case he wants more polarity, so he feeds the ignorant ones a line far from historical truth, or financial truth, etc. since people believe that taking their cues from him is a way to be smart, whatever he says is what they will defend, along with others who follow because that’s what collectivists do.
So if he wants unity, he tells a line close to the same line as the other side, if he wants to polarize and make things more nasty, he slips something in like that. The belly button philosophers pick it up, disseminate it and now you have a split in the coherent strength of the population.
It’s a way to create a false split and two sides, so that you can set them upon each other. Revisionism has a purpose beyond just being historically mean or punishing. It sets people to battle over what’s real. Redirects their attention and makes each believe the other has been soaked in propaganda. It turns mass society into a house of mirrors.
Meanwhile the smarter people cant make sense of it cause they are trying to fit it into a framework that it is not from and doesn’t belong to. They are just perplexed, and rather than change the framework, purpose, or area of the search, they just sit around talking to each other for eternity about ways they haven’t turned the thing to reveal why so stupid.
For your further entertainment
Sarah Palin had her own death panels
http://74.125.95.132/search?q=cache:_qjXL_3J08EJ:www.eeo.state.ak.us/archive-50122.html+%22HEALTHCARE+DECISIONS+DAY%22+palin&cd=1&hl=en&ct=clnk&gl=us&client=firefox-a
State of Alaska > Governor > Proclamations > Proclamations Archive
WHEREAS, Healthcare Decisions Day is designed to raise public awareness of the need to plan ahead for healthcare decisions, related to end of life care and medical decision-making whenever patients are unable to speak for themselves and to encourage the specific use of advance directives to communicate these important healthcare decisions. WHEREAS, in Alaska, Alaska Statute 13.52 provides the specifics of the advance directives law and offers a model form for patient use.
(When you stop being a political hack, I’ll pay more attention, neo)
logern:
(When you stop being a political hack, I’ll pay more attention, neo)
logern, if you weren’t paying attention, you wouldn’t be commenting here. Reminds me of the cartoon I saw decades ago of the little girl pouting.
“I’m never going to speak to her again. And I’m going to tell her so every time I see her.”
Also logern, what Neo quoted was what Medicare PAID SURGEONS. If you can find different evidence regarding what Medicare pays surgeons for amputations from what Neo sourced, please supply the information.
When you compare videos from the past with now you will also start to notice that so many of the things you thought were one way, turned out to be orchestrated.
see this pelosi video
http://www.breitbart.tv/06-flashback-pelosi-tells-anti-war-protesters-im-a-fan-of-disruptors/
January 17, 2006: “So I thank all of you who have spoken out for your courage, your point of view. All of it. Your advocacy is very American and very important.”
and compare it to her words about disrupters now.
you may realize that that past event was a sham. it was meant to make the democrats look like a party that the young can believe and talk to and not have to attack. she seems so magnanamous.
a lot of their speech has nothing to do with the subject, its all about moving material, making things happen.
she wasnt scared then because those werent real protesters in the sense that they were there on their own not part of some group or other clique.
all these people obama, pelosi, dodd, etc.. they are all playing a kind of meta game which helps divisiveness once mixed through the lens of the press and the authors selecting for a divided readership.
“Whom the gods would destroy, they first . . . ”
(OK, I don’t know if that is the correct classical Greek quote, or even a Greek quote, but I read all of Bloom’s “Closing ….” — closely, slowly, and with the feeling my ill-considered actions of 20 years ago have been vindicated — so, I’m owed one misquote.)
Obama isn’t “mad,” but he is, as are so many of his generation, so intellectually lazy, so self-centered, that he has no idea of the quagmire he has stepped into: the real fears and denials of the aged, and the going-to-be-aged soon.
Will they forgive him dashing their hopes of immortality, if only someone else will pay the bill?
C’mon, guys, you’re being too hard on Obama. Obama’s just doing what God would do if He knew the facts of the case.
the difference between
attention
vs
more attention
Pay
more attention
Gringo
logern Says:
“For your further entertainment
Sarah Palin had her own death panels”
Entertainment, yes. Having a point, maybe not the one you mean to have.
Government, and even private insurance, will have a conflict of interest when it comes to your healthcare (and this kind of counseling). Period. The fact that Palin did this or that private insurance might offer similar counseling means nothing…. or rather, it shows my point.
We all know we will have more trouble controlling the conflict of interest when the state on the other side as us (trying to save the actual money itself). For one, right now to some degree we can play the state against the private insurance companies…. and the insurance companies have more trouble getting away with refusal to pay for proven treatments… on the other hand, now the state gets away with arbitrarily refusing to pay for good treatments with Medicaid and Medicare… and gets away with it.
Re the $38,077 number…given that the number cited for the total cost of diabetes included indirect costs, I wouldn’t be surprised if the $38K includes indirect costs–like lost income while absent from work–as well.
That you are still here indicates that you are paying MORE attention: i.e., you paid another visit. Each time you visit the site, the cumulative amount of attention you have paid to the site has increased.
whatsamatta for ya to hang out wit such a bunch uv stups ‘n hacks?
Ozyripus Says:
“Will they forgive him dashing their hopes of immortality, if only someone else will pay the bill?”
On the plus side, ;), at least if this passes it will hasten the passing of the boomers. AND they will have largely been in favor of it while I was against it (clean hands!) and did my best to warn them.
Neo:
That’s pretty typical of liberals and leftists. They’re always expounding on military matters, guns, economics, climate, thermodynamics, and so on and so on…
What Palin encourages is very different from what Obama / Ezekiel Emmanuel encourage.
Everyone should have a discussion regarding end of life measures. This should not be in a coercion free context as well as when death is not imminent. As it is, the terminally ill, whether young or old, are not only dealing with the emotional trauma of their own mortality, they are also dealing with the emotional and financial burden they feel they are imposing on others, especially their own family. To have a third party, the paying party, impose such a conversation in the face of impending death should be unconscionable to any of us who have any measure of respect for another person. You just do not impose on the most vulnerable like that.
The federal and state government already pay hospitals for their indigent care service. Since these are usually life saving measures that require hospitalization, the main care the indigents do not get are preventive care. It remains uncertain whether the cost of providing preventive care will be offset by decreasing treatment. Yes, a little financial boost for indigent care would be nice, but a whole sale transformation of our health care toward socialized medicine is just not necessary. It really smacks of fear mongering and deceit.
It is also noteworthy that while the US has 85% population coverage for healthcare as compared to 100% coverage for UK and Canada, all three with fairly similar culture, all three also have similar life expectancy (78-80 years).
Sarah Palin with her little face book page has been the catalyst, in less that a week, to force the Democrats to eliminate the “death panel” section of the bill, and because of this demonstration of her power, I am sure they hate and fear her even more than they did before.
As emblematic of that hatred, just in the last few minutes a guest on The O’Reilley Factor –apparently a former speech writer for VP Biden–was asked about Palin’s influence on the health care debate, and instead of taking the question seriously and answering it in a calm and reasoned fashion, he sneered that Palin was “totally phony” and that “he fully expected her to be on TV in a couple of years dating Flava Flave.”
The Left is consumed with anger, practically apoplectic, because ordinary Americans are starting to be aroused out of their apathy and are disrupting the smooth progress all on the Left expected for their attempted takeover of America and of all our lives, and, as a result, in their rage the Left and Democrats are wildly flailing about, demonizing and hurling insults at virtually any “enemy” that might be within their reach.
in their rage the Left and Democrats are wildly flailing about, demonizing and hurling insults at virtually any “enemy” that might be within their reach.
It looks like they are realizing they are losing (have lost?) this debate and they are quite angry. I have noticed a lot of claims of racism lately. Just recently one news anchor even said that the word socialism is just a code word for racism.
The left always pulls out the race card when they are losing an argument.
As I recall, Obama’s pastor Jeremiah Wright accused whites of spreading AIDS in the black community.
Wright and his ilk are where Obama gets a lot of his ideas as well as the cadence Obama often uses when he speaks, i.e. the “preacher” cadence.
Obama is always willing to throw out lies or absurdities if he think they will stick. As Artfuldodger so artfully points out, Obama uses the typical ploys of demagogues to divide the people into segments so that he can turn them against each other. The “bad guys” change according to the needs of the day.
Today we have Big Insurance. Yesterday we had Naughty Surgeons and Big Pharma. I guess Big Pharma made a deal with Obama so we probably won’t be hearing about how bad it is for a few days.
When Zero is off teleprompter, he just wings it (air in your tires, pediatricians taking out tonsils, surgeons making big bucks on amputations, etc). What angers me is his gaffes never make it past talk radio or the internet. I did a Google search on Obama + amputation. For the first five pages there was not one reference to a major newspaper or network. I can see why Rush likes to talk about the state run media. They have no shame or integrity.
Obama’s reaction to all this is revealing. He wanted to substantially change the health industry, a huge part of our economy, a very contentious and emotional issue, and he wanted to do it within a few weeks.
When the people reacted with outrage, he and Pelosi and others were . . . confused? Surprised?
These are people who are so totally lacking in knowledge of how things work, so far in over their heads, so completely lacking in awareness, it is stunning.
Couldn’t it be argued that health care cost is so high because of various government interferences? I have read that more than 1/3 of all health care spending is purely administrative.
If we really want “the government” to finance it, why couldn’t we offer a 100% tax credit for health care expenditures?
Why do we spend too much for health care in the US? The Heartland Institute, a public policy think-tank, has listed several reasons:
1) Government subsidies to health care increases demand by artificially lowering costs.
2) Favorable tax treatment of employer-provided health care has the same effect.
3) Lower-income people without health care must rely on emergency room health care delivery at substantially higher cost.
4) Health care buyers and sellers meet in a “market” that is heavily regulated by the government.
5) State governments increase health care costs by mandating benefit coverages.
6) State governments artificially reduce the supply of health care by requiring Certificates of Need before health care providers can expand services.
7) States interfere with the creation and operation of PPOs by fixing prices or the range of services they can offer.
So, really, we have what is, in many ways, the worst of both worlds. We have a market-based system, but one in which market incentives are minimized through regulation and subsidies. In effect, government policy bids up health care prices, while at the same time interfering with the market forces that keep a lid on prices.
The Heartland Institute
http://www.heartland.org/publications/policy%20studies/article/25813/
> His statement was part of a tendency of his to speak out authoritatively on matters about which he knows nothing or almost nothing.
Duh. He’s a Democrat.
> One of the most off-putting things about Obama is his arrogance.
Yeah… He’s a Democrat.
There appear to be two types of Democrats these days — The ignorant gummint-b-good fool and the arrogant elitist boob.
Most Dem politicos are of the latter variety, with some managing to firmly place a foot in both camp, like Nancy Pelosi.
> If Obama was attempting to talk about facilitating better control of diabetes in terms of blood sugar levels, this is already done as best as medicine can currently accomplish it. And once again it depends on patients taking charge of their own lives and health habits, and compliance with things like glucose monitoring and diet.
Ah, but you’re ignoring the fact that the State, since it pays for your health care, will have a vested interest in forcing you to follow its diktat in regards to diet and exercise.
And, being The State, have the power to force
> If Obama was attempting to talk about facilitating better control of diabetes in terms of blood sugar levels, this is already done as best as medicine can currently accomplish it. And once again it depends on patients taking charge of their own lives and health habits, and compliance with things like glucose monitoring and diet.
Ah, but you’re ignoring the fact that the State, since it pays for your health care, will have a vested interest in forcing you to follow its diktat in regards to diet and exercise.
And, being The State, have the power to force obedience to its diktat.
Seig Heil!!!
.
Wow, neo, I’m just now catching up on your recent series of blog entries. And excellent entries too.
I’m a few blog posts late on this, but the one that spoke to me the most was the one called “The Shocking Radicalization of the Center Right.” I’m a member of that newly radicalized Center Right, and I identify fully with that post’s description of my reaction to the Left, and what I have seen as the Left’s reaction to the newly awaked masses speaking truth to the Left’s power.
This whole thing reminds me of an experience I had in college. This was around 1990. I had a neighbor who was a dyed in the wool leftist radical from Berkeley (although the college we were both then attending was not in California, and was in fact quite far from it). He would argue based entirely on baseless assumptions backed up only by emotion. And if you disagreed with you, he would outrighlty call you stupid and act offended that you could not “see the light” of his “progressive” views.
One time, I was talking with my neighbor about socialized medicine, which he strongly supported. As I was not particularly well versed on the issue at the time, I decided to ask him some questions. These were legitimate questions coming from someone who really was quite neutral on the matter(well, maybe more skeptical than neutral, but I was quite willing to be won over by a fair argument). My neighbor could have won me over if only he presented some logical responses to my questions, or even a willingness to be undersatnding of my concerns. Instead, this petty little individual started harranging me about how “free” medical care was a right and how much better Europe was and yadda yadda yadda.
After experiences like this, as well as quite a few other reasons, I got sick of the hard left. For what few scraps of their ideas are actually noteworthy and have a point (and there are a few ), there is a hundred times more BS.
Although I am “Center Right,” I can still be tolerant of some rational, moderate progressivism… and sometimes I may even find myself supporting some moderate, rational portions of that agenda. I am not of the far right. But Obama and the present Dem Congress has shown itself to be of the far left I have grown to despise, and like my former neighbor (I will not call him a friend) they are led by a great many unsupported assumptions backed up only by emotion. For that, I am extremely grateful to this growing grassroots movement that are speaking truth to Leftist power. They are saying to Obama: No, You Cant . . . Not With That Agenda. They are, to quote the former slogan of William F. Buckley’s National Review , taking the brave stance of “standing athwart history yelling ‘STOP!'”
As for this post, I find myself strongly agreeing with the previous comment of huxley:
“I think we are now watching Obama skid through the generous suspension of disbelief to the realization that Obama is just making stuff up.
I can remember wincing at Bush’s malapropisms, grammar malfunctions and his aw-shucksisms but never this kind of “I know it all; let me explain it you” idiocy.
Obama doesn’t know quite a lot. Worse yet – with a nod to Donald Rumsfeld – Obama doesn’t know what he doesn’t know.”
Sounds a lot like my old neighbor in college.
“this petty little individual started harranging me about how “free” medical care was a right”
The next time you were sick and needed a prescription filled you should have presented him with the bill.
He would have objected to paying it, of course, but you could have asked him to explain how it was that you couldn’t demand he pay your bills but you could demand that someone else you didn’t even know did. This whole “health care is a right” argument is the biggest pile of crap on the face of the planet. We might choose to make it a policy, as a nation, but it’s not a right. No “rights” exist that require the confiscation of money or services from somewhere else. That is slavery, and that’s the opposite of human rights.
“somewhere” should be “someone” in the second to last sentence.
P.S. Isn’t it amazing how some people are so eager to spend other people’s money but have a real hard time parting with their own. That’s why Margaret Thatcher’s statement is so accurate – the one about the problem with socialism being that eventually you run out of other people’s money. It’s sooo much easier to commit someone else’s money to a problem.
You guys should be down on your knees praising democracy.
Did the last administration even try to engage the public in its controversial policies, if even to show up at a public town hall and announce its critics rabble?
No, not even that.
…and it looks like the coward Cheney, hid behind Bush, while pushing his agenda. I still don’t think he’s done anything but carefully choreographed appearences with a select or limited audience since he left office.
logern Says:
“Did the last administration even try to engage the public in its controversial policies, if even to show up at a public town hall and announce its critics rabble? ”
Not so much… then again, these guys just blindsided the dems. I’m sure they’ll switch to being no better than Bush now that they know there are protests (ah la Obama’s fake town hall)….
“You guys should be down on your knees praising democracy.”
You have a strange notion of Democracy, the last administration didn’t try and silence anyone. At the least I do not see any protesters that were beat to the point of being wheel chair bound by the official security.
While I did not and do not like their silence I find it a great deal better than beatings, the truth e-mail site, and the other attempts to silence the opposition. Lots of ranting about Bush *wanting* to do that (and for all I know it was his number one desire), but in this case we have it *in action*.
But then I have noticed that any time a Republican gets in office the left projects what they want to do on to them and then once they get power actually follow through with it.
Sure Bush may have had wet dreams about doing this type of thing, yet only you guys have actually followed through and done them (along with saying my side wanted too a justification – well your side wanted to kill my side according to your posters so it is OK if I kill all of you? I bet not).
Yep, keep up with that one, unfortunately once you get to hold the reigns opposition politics doesn’t work well. Especially true when you are doing what you claimed was horrid when the other side only thought about it. Watch Obama’s number plummet to where we find the Good Ole’ Days of Bush – but then take heart in that Republicans tend to be even more incompetent at choosing mid term candidates than you guys!
“My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff.
“Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens….An obvious example is not guaranteeing health services to patients with dementia.” [10]
“Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” “
ATTENUATED. By denial of medical care.
The foregoing is from Sarah Palin’s press release in rebuttal to the hysterical reactions against her description of future death panels deciding who gets to live.
As you can see from Emanuel’s quote above, that is EXACTLY what they have in mind.
Note, too, that he’s willing to deny care to the YOUNGEST as well. Babies.
This isn’t right-wing histrionics: Out of their own mouths, they condemn themselves.
Thomass:
“…the insurance companies have more trouble getting away with refusal to pay for proven treatments… on the other hand, now the state gets away with arbitrarily refusing to pay for good treatments with Medicaid and Medicare… and gets away with it.”
Exactly.
“You guys should be down on your knees praising democracy.”
Hey, we’re not the ones who keep trying to drag the country toward the socialist, collectivisit end of the political spectrum where individual rights get trampled. It’s you nanny-staters who do that, with your belief that you know what’s best for everyone and therefore you’ll decide how they live instead of letting them decide. We know the value of democracy and have worked hard to preserve it for over 200 years. It’s your side that doesn’t always seem to have a firm grasp on the great gift our founding fathers bequeathed to us, and are willing to throw it away for a few baubles.
We’re a republic, logern. I am very thankful for that. Were we a democracy where a mob can rule, all Obama wants would already be law. He has the majority vote wise, even if misguided.
Gotta love the ABC news blurb I see up on Drudge. Fear grows for the president’s safety? Come on. Fear he may not see a second term, perhaps. Fear he won’t get all his crap pushed through, perhaps. ABC News, aren’t they the official White House News Corps now – with offices near ACORN and the census bureau?
And they’re scared?
logern Says:
Did the last administration even try to engage the public in its controversial policies, if even to show up at a public town hall and announce its critics rabble?
You’ve deluded yourself into believing that the Obama administration had a choice. They had no intent on engaging the public. They clearly expressed their intent on ramming this through BEFORE the August recess. The administration was so desperate they deployed attack ads against their own party. Resulting in Democratic Senator Nelson complaining that Nebraskans were now calling his office 9 to 1 in opposition to Obama’s Health Care reform. Blue Dog Democrats tried to negotiate with the far left wing. Then talks broke down because they had “been lied to”.
The Obama administration has demonstrated time and time again they have no interest in engaging the public. Obama has blatantly lied at least a dozen times during his town halls: support from AARP, the cost of an amputation, savings from Medicare, a deal cut with PhRMA, etc. etc. and his administration and Congress have called Americans “brownshirts”, “un-American”, “Astroturf”, “swastika carrying”, and “political terrorists”. They’ve attempted to define townhall participants with images of the KKK and Tim McVeigh, even while they’ve emboldened union thugs to attack citizens.
Yeah, they want to engage the public, all right.
Yeah, they want to engage the public, all right.
“Yeah, they want to engage the public, all right. ”
Well, in his defense hiring union thugs to beat up protesters is a form of engaging. So is calling us brownshirts, Nazi’s, and all that other stuff.
So, in that sense he is almost 100% correct – they *are* going out of their way to engage with us. He is wrong about that being democracy (also not a good republic), but they have certainly went out of their way since the very beginning to engage with us.
Beverly Says:
August 15th, 2009 at 3:50 am
“As you can see from Emanuel’s quote above, that is EXACTLY what they have in mind. ”
Well said Beverly.
Just a couple weeks ago the Drudge Report posted the headline and link, “Uncovered Video: Obama Explains How His Health Care Plan Will ‘Eliminate’ Private Insurance…”.
In the video Obama clearly states, “I don’t think we’re going to eliminate employer coverage immediately. There’s going to be potentially some transition process. I can envision a decade out or 15 years out or 20 years out.”
As anyone can plainly see the Drudge headline quoted Obama’s comments almost verbatum, yet Obama’s propaganda minister, Linda Douglass, had the audacity to call it misinformation, claiming that the comments were taken out of context and co-opted all americans to inform on ‘fishy’ websites.
Viewing the full video at 1:28 it is obvious it wasn’t taken out of context.
:28.
Obama’s intent is crystal clear. He views his public option as a stepping stone to single payer. This view is also supported by Barney Frank. The painful conclusion: all of their promises of you keeping your insurance and your doctor are just a carefully packaged pack of lies.
strcpy Says:
“You have a strange notion of Democracy, the last administration didn’t try and silence anyone.”
Bush did keep hostile people out of his town halls. I think some of his questions were also from plants. Were they all? I don’t know.
On the other hand, when Bush did it, it was news….
Yeah. Gotta get rid of the Lebensunwertes Leben. Racial hygiene and all that. Except that this time criminals and homosexuals will be exempted, as they are core constituencies.
What is it with color coded badguys?!? Hitler had his brownshirts and Obummer has his purpleshirts. BTW; purple? Who thunk that one up?
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“Yeah, they want to engage the public, all right.”
By lying about what they’re doing, insulting the people they’re supposed to represent, and trying to sneak bills through before anyone knows what’s going on they haven’t engaged the public, they have enraged the public. And now they’re seeing the result. It couldn’t happen to a nicer bunch of people.
Community organizers. Is there anything they don’t know?
OB: Community organizers. Is there anything they don’t know?
The only thing they don’t know is that they are not all-knowing.
Logern says: Sarah Palin had her own death panels …
Logern doesn’t know the difference between a general proclamation encouraging folks to make decisions on health care and legislatively mandating a panel of “end of life” government “counselors.” Sarah Palin never had her own “death panels.”
I find it very revealing that Logern himself, with his own language, acknowledges that the government “end of life” counselors were indeed actually “death panels.” The Progressive don’t realize that the more they chatter about “death panels” never existing the more they spread the term(which is quite accurate).
A government employee would show up every once in awhile to tell grandma, “Hey, just in case you want to stop being a ‘burden’ on your family, I’m here to tell you how you can do that.” As far as I’m concerned “death panel” is a VERY apt term for such a thing.
On a related subject, before the healthcare debate, even before Obama’s election, I saw references in various venues about “living wills.” I was curious and looked the term up, which is also called an “advanced heath care directive,” and was puzzled why it would be considered such a necessity by folks. Can anyone tell me why a “living will” is a necessary thing? It seems to me to be just another unnecessary monetary boon to lawyers. I’m open to argument.
Grackle, the push by health care providers and lawyers to ensure all people have living wills is ostensibly to avoid unwanted life-extending treatments that can occur in end-of-life situations. Doctors are required to resuscitate patients and preserve life, unless there is a do not resuscitate order (DNR) in place, as outlined in a living will.
In practice however, it’s nearly always the wishes of the patient’s immediate family that take precedence. So the best thing people can do is decide what kind of care they want in extreme situations, and then convince their loved ones to carry out their wishes. And hope they don’t change their minds!
These decisions are private and personal, and most of us flinch from the thought of intrusive government- required counseling on end of life decisions. Why the proposed Obama plan has such a huge pricetag for such “counseling” is beyond me. Doctors do this kind of thing as part of their routine care of patients anyway. Unless it’s a workfare scam designed to put more people on the government payroll. If so, this is just another way to confiscate more of our money.
Everything I know about living wills you could pack into a subplot on a 22-minute episode of Seinfeld.
Oh … they did that already?
http://en.wikipedia.org/wiki/The_Comeback_(Seinfeld)
Grackle, the push by health care providers and lawyers to ensure all people have living wills is ostensibly to avoid unwanted life-extending treatments that can occur in end-of-life situations. Doctors are required to resuscitate patients and preserve life, unless there is a do not resuscitate order (DNR) in place, as outlined in a living will.
With all due respect, E, your explanation did not answer my question. There is an easy way a doctor can “avoid unwanted life-extending treatments that can occur in end-of-life situations;” they can ask the patient what the patient’s wishes are. If something is “unwanted” the patient can tell the doctor. Where is the necessity for a “living will?” I think I know why the lawyers want it; it is obviously another source of income for lawyers. Folks have a tendency to believe things are necessary if those things put money in their pockets.
I find it un-startling that doctors are required to “resuscitate patients and preserve life,” since I have always thought this was what doctors were supposed to do.
I’m puzzled why someone would want to NOT be resuscitated. Are there that many people who would not want a lifeguard to perform mouth to mouth CPR? I’ve not heard of any. Isn’t this why defibrillation machines were invented — to revive folks whose hearts have stopped?
Hey, Grackle, I’m with you. I think a living will is a way for doctors and lawyers to cover their asses in difficult situations. That being said, there are times when doctors can’t ask a patient what they want – suppose they’re unconscious? And suppose there are no relatives to ask?
There are situations outside of the kind that crop up at the local pool or at the gym where life-saving procedures might not be the best idea – imagine someone with a chronic, debilitating illness who has reached the point where they can’t breathe on their own? Do you intubate that patient regardless of their wishes? Or let them die naturally?
I think we can agree that only the patients themselves, their doctors, and their loved ones should be having discussions about what kind of care such patients should receive.
… there are times when doctors can’t ask a patient what they want – suppose they’re unconscious?
Then the doctor should wait until the patient regains consciousness and then ask the patient.
Anyway, I would think that in most cases where a patient would be unconscious and not able to relay his/her wishes to the doctor that the doctor could not be aware whether the patient possessed a living will or not. After all, living wills are not items commonly carried around in a billfold or a purse like other documents, i.e.: identification, insurance cards, etc. So the doctor, not having any way to know the wishes of the patient necessarily has to wait until the next of kin is available to ask what to do, even if a living will is filed away somewhere.
E, I’m not arguing with you; I’m trying to reduce the issue into its simplest components, to strip away the excuses and obfuscation commonly used to rationalize this manufactured need where I believe no real need exists.
Most folks who espouse living wills probably mean well. But as the old cliché goes: The road to Hell is paved with good intentions. And I also think it is very easy to rationalize a need when it will produce an income-generating activity. You see, lawyers are lawyers — if your preferred tool is a hammer everything tends to look like a nail. If any lawyers are reading this I urge them to join in the discussion.
I’m sure the doctors would prefer an unambiguous situation but speaking for myself I would just as soon the doctor would wait around until it is certain that I will never regain consciousness instead of pulling the plug because I cannot be asked right away. People DO come out of comas, you know. It’s not all that unusual.
What has happened before is that doctors would ask the patient. If the patient was in such a condition that the patient would never regain consciousness and could NOT be asked then the next of kin were asked what to do. If there were no next of kin, then the doctor would quietly allow the breathing to lapse after a decent period of time.
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E and Grackle,
My experience as a critical care RN leads me to believe that Living Wills are worthless. If the patient stated that he did not want to be resuscitated, OR there was a valid DNR in the chart, then the patient would not be resuscitated if his heart stopped or he stopped breathing. I cannot recall a living will ever being referred to.
Barring stated wishes or a DNR, the patient would be resuscitated, or, rather, the attempt would be made, unless a valid health care proxy stated otherwise. In any event, the decision to NOT resuscitate would be made by the patient or kin. If it was not clear, or explicit, resuscitation attempts would be made.
Sadly, resuscitation rarely leads to a happy outcome. All those defibrilators are there for the rare occasion when they restart the heart, and the patient is able to resume something of a normal life. It doesn’t happen often.
E, I liked your comments early in the thread. It IS personal. It isn’t the government, after all, who has developed things like insulin pumps, or Lantus. I’d hate to see that kind of innovation stymied by bureacracy. –
fmt: Thanks for the nitty-gritty.
fmt: what huxley said!
Don’t fall for the head fake Neo.
Sunday morning talk shows had it all wrong.
Democrats will not give up the “public option”.
http://www.redstate.com/california_yankee/2009/08/16/does-a-death-panel-equivalent-already-exist/
Obama said a surgeon gets $50,000 for an amputation.
People actually believe doctors get that kind of money for surgical procedures.
A lawyer would charge $50,000 for the paperwork a surgeon must do prior to doing a leg amputation.
A surgeon doing an amputation on a Medicare patient which is the vast majority of patients who require amputations are paid $700 for the amputation this includes all paper work and 90 days of postoperative care. It can come down to less than $10 per hour.
A lawyer has a much lower SAT score in reading comprehension than a Doctor and only 3 years of postgraduate education. many lawyers I know were bottom of the class paople there bright ones also.
What is wrong with Obama and the publics misconception of Doctors who work practically for free and are the best and brightest we have.
blah
I stumbled across this blog while looking for some discussion about Obama’s $50,000 leg amputation comment and the follow-on from the ACS. And, discovered Neo-Neocon.
I appreciated a thoughtful view of Obama’s loose rhetoric both from Neo and from the replies. But, there is also a lot of anti-Obama emotion in these replies. I, personally, have found Obama to be very thoughtful and careful in explaining / espousing his ideas. I haven’t heard him reply to this criticism and until he does, I am finding the criticism believable. So, I hope he will – either to argue his point or acknowledge he was wrong.
But, I see a bigger issue here. With all due respect, Obama’s comments light up a firestorm about a peripheral issue. As wrong as he might be about the leg amputation costs, that is a “B” or “C” issue. The “A” issue is what we as a society will or can do about overall health care costs.
I want to hear what people think about costs. We usually slide past A issues because they are hard.