Watched Prez Osama's speech to the AMA. First, very generally, something I find very disturbing about this person is the odd, almost drunken expression he gets on his face when people applaud him. He literally looks like he's melting into some sort of ga-ga emotion. This is positively weird. I'm not sure if this is narcissism or what. Sort of reminds me of Sally Field's "You love me! You really love me!" Only Sally Field didn't seem to abandon all reason the way the prez does. Is he so undone by flattery?
Regarding the speech itself, it raises more questions than it answers. What particularly struck me -- and I'm sure left many doctors wondering, as well -- is the changes in payment that Osama is proposing.
1.) Osama says doctors' pay should be "outcome-based." What the heck does that mean? If a patient dies, they don't get paid? If they misdiagnose something, they don't get paid? It is possible to misdiagnose something honestly, when one condition disguises another, for example, or if doctors are restricted in the diagnostic tests they can perform -- which is another proposal the prez made. Or, maybe the patient simply doesn't follow directions. Anyway, what exactly is "outcome-based pay" for doctors?
2.) Osama said doctors shouldn't be paid on a case-by-case basis, but for a whole treatment. Maybe he doesn't understand how doctors work? You don't get a cardiac surgeon to monitor after-surgery care, for example. A dermatologist might consult without contributing anything more. What constitutes a"whole treatment"?
To me, this sounds like he's suggesting that doctors take some kind of salary, no doubt determined by the Paymaster General, the new Compensation Czar Osama named last week. After all, once he's determined how much people at AIG and GM can make, this new czar will have plenty of time on his hands to try to control health care providers. Got to keep these government dudes busy or the general public might begin to wonder why, exactly, we have a Paymaster General in the first place, and that might lead to diminishing the number of people who can dictate policy without benefit of congressional input and reduce Osama's power. We couldn't have that in this administration.
3.) Osama says doctors should get bonuses when they're successful. Oh well, they used to have bonuses in the financial industry, and see how that worked out? The SEIU and Acorn didn't like it at all. It might indicate that some people are more equal than others. And exactly what kind of bonuses would doctors get? If they don't leave a sponge in your tummy after an appendectomy? If they actually cure someone? That's their job, isn't it?
Or is Osama talking about research? It's a possibility. Is research covered under Osama's health care plan? Where? In other nations with socialized medicine, research has been the first thing to go -- just too damn expensive.
4.) Osama keeps talking about preventive medicine. (He's actually says "preventative" -- which is a word that people have just made up. You really don't need the extra syllable.) Anway, preventive medicine has added considerably to the cost of health care in general. For example, getting that yearly PAP smear, mammogram, or now prostate exams. Even for people who have no family history of these problems or any symptoms. OK. Catching anything early can help to "cure" it, but the vast majority of these tests reveal nothing but a clean bill of health. And they cost the same whether doctors find anything or not.
I'm not saying regular testing is a bad idea; I'm just saying it's expensive and it won't reduce costs, except in those cases that do reveal a potential problem, and these are a very small percentage of cases.
Also, I've heard that these types of preventive tests actually are more useful for keeping machines busy to help pay down their costs. I mean, in any industry, you buy an expensive new machine, you've got to keep it going 24/7 to get any return-on-investment from it. The health care industry is not immune to this reality. It's like, you get a brand new MRI machine, you've got to start stacking up bodies to keep scanning pretty much 24 hours per day to keep up the payments on it.
And "prevention" generally means no smoking, eat a healthy diet, exercise regularly. So, how is this going to happen? Everybody already knows this. No matter how many billboards about cancer are pasted onto cigarette packs, 20% of Americans still smoke. Junk food is a whole industry. Kids don't like vegetables. I would guess that more people watch exercise on TV than actually exercise. That home stationery bicycle is useful mainly as a clothes hanger.
So how is this type of prevention to be enforced?
Picture droves of Health Care Tactical Squads in bright red lab coats and ski masks descending upon a suburban neighborhood, rousting couch potatoes from their living rooms and locking them into cages with just enough room for a treadmill. "Run!" they cry, holding a stop watch. "Run! Fifteen minutes and you'll get a Twinkie." And the Twinkie will be made of dessicated bean spouts and reconstituted soy milk.
I just can't wait.
Anyway.... Change of subject....
As I was signing on to the computer, heard that the Grand Wise and Perfectly Holy Poobahs in Iran are now firing upon the people who suspect election fraud in Iran. I mean, the protesters are being shot at and at least one apparently was killed. That's a sure sign of moral impeccability -- killing people who disagree with you.
Difficult to verify what's going on, since the Iranian government -- or should we say Holy Pantheon -- is blacking out all public communications, including cell phone service, Twitter, FaceBook and so on. I'm surprised they busy themselves with such trivia as technology. Why can't they just wave their magic wands?
Looks like a preview of the US's future, if, heaven forbid, we persist in smoking cigarettes, guzzling Coca-Cola, and munching on Cheetos. I mean, don't we absolutely need to be regulated? Life is just to precious to leave how and why we live all up to us as individuals. What we need is more and more control, layers of more government to make our decisions for us.
Somehow, I can't believe this is what George Washington, Tom Jefferson, Ben Franklin, John Adams, et. al., had in mind. And I don't believe the principles behind fair government change at all, no matter how big and complex a nation becomes. To call the USA a "free" country anymore is to misuse the word "free." Increasingly, it's becoming an over-taxed, over-regulated, and oppressive country.
My favorite quote is from Tom Jefferson: "If man is not fit to rule himself, how then can be fit to rule others?"
I guess the answer to that one is: You've got to manufacture some kind of Messiah with magical powers.
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