Thread: Obama outlines health care plan for all

This is why doctors will be looking into going to law school instead of practicing medicine under this plan. Can't blame them really. It is also why healthcare in rural areas will dry up and die, but hey as long as illegals in major cities are covered then well ok.

Wednesday, December 30, 2009
This Health Care Turkey Should Be Done

I do not underestimate the ability of the Democratic majority in Congress, under intense pressure from the White House, to pass some form of health care bill. What will pass, if it does, will be very, very close to the Senate bill passed on Christmas eve.

In a rational world, this health care turkey would be done, and we'd be sticking a fork in it. Here are some of the events of the past couple of days, in no particular order, which reflect a rational assessment of the bill:

Bob Herbert, Obama supporter, tore the bill apart as "a middle-class tax time bomb" misleadingly marketed as something it is not. http://legalinsurrection.blogspot.co...d-you-lie.html


The Governors of the two largest Democratic states, California and New York, ripped the bill as imposing crushing burdens on state budgets. http://www.politico.com/news/stories/1209/31032.html


58% of voters oppose the bill, in the latest Rasmussen poll http://www.rasmussenreports.com/publ...den_58_opposed a number which actually rose to 60% after the interviewees were given more information about specific health care issues; 78% are convinced that the bill will cost more than projected. http://www.rasmussenreports.com/publ...than_projected


67% of voters think the country is heading in the wrong direction, a number which jumps to 75% among unaffiliated voters. http://www.rasmussenreports.com/publ...or_wrong_track


Everyone knows that conservatives hate the mandates in bill, but the Left does too, with mounting calls for the Left and Right to join together to kill the mandate. http://firedoglake.com/2009/12/30/ri...neo-feudalism/

This bill should have been dead a long time ago. All that remains is a rotting corpse of health care reforms which do much harm and little good.

Let's hope we can kill this disaster waiting to happen before it happens.

http://legalinsurrection.blogspot.co...d-be-done.html

Dems intend to bypass GOP on health compromise
By David Espo, Ap Special Correspondent
1 min ago

WASHINGTON – House and Senate Democrats intend to bypass traditional procedures when they negotiate a final compromise on health care legislation, officials said Monday, a move that will exclude Republican lawmakers and reduce their ability to delay or force politically troubling votes in both houses.

The unofficial timetable calls for final passage of the measure to remake the nation's health care system by the time President Barack Obama delivers his State of the Union address, probably in early February.

Democratic aides said the final compromise talks would essentially be a three-way negotiation involving top Democrats in the House and Senate and the White House, a structure that gives unusual latitude to Senate Majority Leader Harry Reid of Nevada and Speaker Nancy Pelosi of California.

These officials said there are no plans to appoint a formal House-Senate conference committee, the method Congress most often uses to reconcile differing bills. Under that customary format, a committee chairman is appointed to preside, and other senior lawmakers from both parties and houses participate in typically perfunctory public meetings while the meaningful negotiations occur behind closed doors.

In this case, the plan is to skip the formal meetings, reach an agreement, then have the two houses vote as quickly as possible. A 60-vote Senate majority would be required in advance of final passage.

"I look forward to working with members of the House, the Senate and President Obama to reconcile our bills and send the final legislation to the president's desk as soon as possible," Pelosi said late last year as the Senate approved its version of the legislation.

"We hope to get a bill done as soon as possible," said Jim Manley, a spokesman for Reid.

The issue is so partisan that only one Republican, Rep. Anh "Joseph" Cao of Louisiana, has cast a vote in favor of the legislation.

GOP leaders have vowed to try and block a final bill from reaching Obama's desk. "This fight isn't over. My colleagues and I will work to stop this bill from becoming law," Sen. Mitch McConnell, R-Ky., the Republican leader, said shortly before the Senate cleared its version of the bill last month.

Both houses have already passed legislation to remake the health care system, extending coverage to millions who lack it while cracking down on industry practices such as denying insurance on the basis of pre-existing medical conditions.

There are literally hundreds of differences between the two bills, a House measure that ran to 1,990 pages and a Senate version of 2,074, not counting 383 pages of last-minute changes. The biggest differences involve a dispute over a government-run insurance option — the House wants one, but the Senate bill omitted it — as well as the size and extent of federal subsidies to help lower-income families afford coverage.

Bypassing a formal conference committee enables Democrats to omit time-consuming procedural steps in the Senate and prevents Republicans from trying to delay the final negotiations.

Under Senate rules, three separate votes are required before negotiators for the two houses may hold a formal meeting. While the three normally are agreed to within seconds, each may be filibustered, and Democrats would then have to produce 60 votes to cut off debate.

Additionally, Republicans would have the right to demand votes on nonbinding proposals once negotiators for the two houses were appointed. That could, in turn, require Democrats to vote on political controversies such as wiping out the legislation's proposed cuts in Medicare, the type of issue that could easily be turned into attack ads in next fall's campaign.

Congress plans no formal sessions until Jan. 19, but Pelosi intends to meet this week with key committee chairmen and other leaders, and a separate meeting is also planned for members of the rank and file.


http://news.yahoo.com/s/ap/20100105/...1zaW50ZW5kdG8-

It sounds like the Democrats will use any means whether legal or not to get this passed even though the polls show that the majority of people do NOT want this horrendous monstrosity that they want to call healthcare.
Thanks

C-SPAN: Health care talks should be televised
Tue Jan 5, 10:51 am ET

WASHINGTON – The C-SPAN television network is calling on congressional leaders to open health care talks to cameras — something President Barack Obama promised as a candidate.

Instead the most critical negotiations on Obama's health plan have taken place behind closed doors, as Republicans repeatedly point out. In a Dec. 30 letter to House and Senate leaders released Tuesday, C-SPAN chief executive Brian Lamb asked for negotiations on a compromise bill to be opened up for public viewing, as Democrats work to reconcile differences between legislation passed by the two chambers.

Obama pledged during a presidential debate in January 2008 that he would be "bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are."


http://news.yahoo.com/s/ap/20100105/...NwYW5oZWFsdGg-

more ridiculous infomercials..........:

Different health care reform: doctors trained to deal with patients about faith
By Wendy Cadge
Tue Jan 5, 11:23 am ET

Waltham, Mass. – Modern medicine, with its profound dependence on technology, often seems nothing short of miraculous. But even the best medicine sometimes falls short of offering a successful treatment or cure. It is in these situations that recent national surveys show many Americans think God can help.

Indeed, three-quarters of Americans believe God can cure people who have been given no chance of survival by medical science. More than half of Americans regularly pray for their own health or the health of their family. Yet many physicians are unwilling, or ill-equipped, to support patients and families on this level.

Many doctors see religion and spirituality as a barrier to medical care or, at most, a useful crutch when medicine has no more answers. But healing involves more than just medical diagnosis and treatment. Often patients and families see spirituality as a source of support when they are ill, or appear to be dying.

A holistic approach to medicine requires physicians to understand the complex role of spirituality and religion in compassionate patient care. The best prescription: Integrate these topics throughout medical education.

What physicians get trained to doRice University sociologist Elaine Howard Ecklund and I wanted to find out how physicians respond to patients’ spiritual and religious beliefs in their work. Of the 30 academic pediatricians and pediatric oncologists we interviewed, few learned about spiritual or religious issues they might encounter in patient care during their formal medical education.

About a third spoke informally with colleagues about issues of religion during training. Some reported taking steps on their own to get to know hospital chaplains and talk with them about death and dying, family decisionmaking, and how to respond to patients and families who are very religious – especially Jehovah’s Witnesses and Orthodox Jews.

Almost none of the physicians we interviewed learned how to respond to religion and spirituality as they often learn other skills – by observing how senior physicians model them.

In another recent national study of physicians, University of Chicago physician Farr Curlin found that only a quarter of the physicians surveyed reported having received any formal training at the intersection of spirituality, religion, and medicine.

This may be changing, however, as a growing number of medical schools – many with the support of the George Washington Institute of Spirituality and Health (GWish) – started offering courses about spirituality and religion during the past 20 years. These courses try to prepare students to engage in a broad range of conversations about spirituality and religion. Individual courses vary significantly, however, leading GWish to collaborate with medical schools to develop six core competencies in spiritual and health education and to design a uniform way to measure and evaluate them.

While such top-down efforts are a good beginning, it’s clear that most practicing physicians have at least some level of discomfort regarding spirituality in their work, and some consider it a real source of conflict. Our bottom-up research approach – based on talking to physicians in the field – convinces us that a more nuanced, flexible approach to helping doctors and medical students navigate the spiritual shoals is needed.

A holistic approachFirst, physician educators must pay attention to the way they and their colleagues act around spirituality and religion in their work. Too many debates about spirituality in medicine are focused on what physicians should do rather than what they are actually doing now.

While some are silent, others have developed ways of responding to or accommodating discussions of spirituality and religion that may be instructive. For example, we asked physicians whether prayer comes up in their work. All reported that it does, at least occasionally, usually when a patient or family member asks them to pray for them.

The physicians described a range of ways they respond to these prayer requests. While a few do pray with patients, many more reframe such requests in ways that feel more comfortable to them. They might stand silently in support of patients while family members or chaplains offer prayers, for example, or speak at funerals rather than lead prayers, as some families have asked.

Second, doctors should pay more attention both to people’s religious traditions and to their broader senses of spirituality and meaning.

Given recent survey data showing how often people combine religion and spirituality, and how helpful either one or both can be, being sensitive to questions of spirituality and of religion is especially important.

This means engaging with patients when they want to talk about their religious background or attending religious services and being open to broader conversations about spirituality and meaning.

There are lots of different “spiritual tools” available for physicians. One example is a set of questions healthcare providers can ask patients to gather information from them about their religion or spiritual needs. Having questions on hand that address faith and belief and how medical professionals can address these issues in healthcare can help.

Third, it makes sense to systematically include hospital chaplains and nurses in educational initiatives. Two-thirds of American hospitals have chaplains, and nurses have a much longer tradition of talking with patients about spirituality and religion at the bedside than do physicians. Nurses also often spend more time with patients than do physicians.

Although physicians frequently spoke with us about Jehovah’s Witnesses and Orthodox Jews, it is important for them to remember that a broader range of people see spirituality and religion as important to their healthcare.

It seems that physicians often forget that religious and spiritual issues are important to people all the time, not just when chaplains are called in hospitals, which is often in end-of-life situations.

A holistic approach to taking care of people, one that will most help those who seek healing, means that more doctors will have to begin to understand patients’ complex relationships to spirituality and religion, rather than ignoring them.

Wendy Cadge is associate professor of sociology at Brandeis University in Waltham, Mass. She is working on her second book, “Paging God: Religion in the Halls of Medicine.”


http://news.yahoo.com/s/csm/20100105...ZmZXJlbnRoZWE-

White House put on the defensive on health care
By Erica Werner, Associated Press Writer
8 mins ago

WASHINGTON – The White House was put on the defensive Wednesday after President Barack Obama pushed congressional leaders to fast-track health care legislation behind closed doors despite his campaign promises of an open process.

"The president wants to get a bill to his desk as quickly as possible," Press Secretary Robert Gibbs said as reporters questioned him repeatedly about Obama's decision to go along with House and Senate leaders in bypassing the usual negotiations between the two chambers in the interest of speed.

The decision was made in an Oval Office meeting Tuesday evening with House Speaker Nancy Pelosi and House Majority Leader Steny Hoyer. Senate Majority Leader Harry Reid and his No. 2, Sen. Dick Durbin, D-Ill., joined in by phone.

They agreed that rather than setting up a formal conference committee to resolve differences between health bills passed last year by the House and Senate, the House will work off the Senate's version, amend it and send it back to the Senate for final passage, according to a House leadership aide, speaking on condition of anonymity in order to discuss the private meeting.

Obama himself will take a hands-on role, and is convening another meeting with congressional leaders at the White House on Wednesday. Pelosi and four Democratic committee leaders are expected to attend.

Gibbs told reporters Wednesday to "ask the leaders in Congress" about the fast-track approach, even though Obama was involved in making it and the closed nature of the proceedings is at odds with a promise he made while campaigning for president. In a January 2008 debate, Obama said that his approach to health care talks would involve "bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are."

Republicans have jumped on the contradiction to accuse Obama and Democrats of operating in secret, an assertion Democrats dispute. "There has never been a more open process for any legislation in anyone who serves here's experience," Pelosi declared at a news conference Tuesday.

Asked about Obama's campaign trail promise, Pelosi remarked, without elaboration, "There are a number of things he was for on the campaign trail."

Pelosi spokesman Brendan Daly said Wednesday it was not a slap at the president. "It was a quip," Daly said.

The fast-track process isn't unheard of in Congress but it is unusual. Democrats passed their health care bills by razor-thin margins and with barely any Republican support last year. The quick approach to reconcile the bills will exclude GOP lawmakers and reduce the party's ability to delay or force politically troubling votes in both houses.

Ahead of Wednesday's White House meeting Pelosi summoned her top lieutenants and committee chairmen to search for concessions and trade-offs they can reach with the Senate in order to deliver a bill to Obama in time for the State of the Union speech sometime early next month.

House Democrats are reluctant to abandon elements of their legislation favored by liberals but rejected by Senate moderates, but face doing just that. Reid has no votes to spare in his 60-member caucus so the legislation must be largely tailored along the lines favored by the Senate.

That means no new government insurance plan, which the House wanted but the Senate omitted, and changes to the House's preferred payment scheme. The House wants to raise income taxes on individuals making more than $500,000 and couples over $1 million. The Senate would slap a new tax on high-cost insurance plans. Although the Obama administration supports the Senate's insurance tax as a cost-saver, labor unions, which contribute heavily to Democratic candidates, oppose it.

House Rules Committee Chairman Louise Slaughter, D-N.Y., said that leaders spent Wednesday morning comparing the House and Senate bills, and "concluded as we always do that our bill is so much better."

Nonetheless Slaughter, like others, sounded ready to deal. On the different taxation approaches, "There's a lot of talk about whether there'd be sort of a hybrid between ours and the Senate," she said.

The House may end up accepting the insurance tax if it hits fewer people than the Senate's design now calls for. There also could be common ground on a Senate proposal to raise Medicare payroll taxes.

In place of a new government insurance plan House Democrats plan to insist on stronger affordability measures for the middle and lower classes, and they also favor revoking insurers' antitrust exemption. Obama agreed at Tuesday evening's meeting to help strengthen affordability measures beyond what's in the Senate bill, the aide said.

The bills passed by the House and Senate both would require nearly all Americans to get coverage and would provide subsidies for many who can't afford the cost, but they differ on hundreds of details. Among them are whom to tax, how many people to cover, how to restrict taxpayer funding for abortion and whether illegal immigrants should be allowed to buy coverage in the new markets with their own money.

Concerns about affordability are paramount. Major subsidies under the bills wouldn't start flowing to consumers until 2013 at the earliest. Even with federal aid, many families still would face substantial costs.

The House bill would provide $602 billion in subsidies from 2013-2019, covering an additional 36 million people. The Senate bill would start the aid a year later, providing $436 billion in subsidies from 2014-2019, and reducing the number of uninsured by 31 million.

But sweetening the deal for low- and middle-income households could require more taxes to pay for additional subsidies.

http://news.yahoo.com/s/ap/20100106/...RlaG91c2VwdQ--

Will health care reform reduce the relentless rise in costs?
Mon Dec 21, 2:55 pm ET
By Christina D. Romer

As the Senate moves closer to a critical vote on the Patient Protection and Affordable Care Act, a key issue in the debate is the extent to which reform will actually slow the relentless growth of health care spending. New evidence brought together by the Council of Economic Advisers (CEA) shows that the legislation will genuinely bring down health costs over time, resulting in higher standards of living for American workers, greater private sector job creation, and lower government budget deficits.

The need to slow spending growth is uncontroversial, as families, businesses, and governments at every level are struggling to cope with soaring costs. Each year, a larger share of workers’ total compensation, and of Medicare recipients’ Social Security benefits, is eaten up by insurance premiums. Each year, fewer businesses, and especially small businesses, can afford to offer health insurance to their workers. And each year, a larger share of spending at all levels of government goes to health care, which has led to tax increases, cuts in other programs, and higher deficits.

That’s why achieving health reform that provides quality, affordable care while genuinely taming the growth rate of spending has been a top priority for the President. .

The Senate bill includes changes to Medicare and Medicaid that reduce wasteful spending and fraud. For example, it saves more than $100 billion over the next decade by reducing unnecessary overpayments to Medicare Advantage plans. It also includes common-sense, care-improving, cost-reducing delivery reforms. For example, it creates a pilot program for the formation of accountable care organizations that encourage doctors to function as an effective team, and payment reforms that penalize hospitals for preventable infections. The creation of an Independent Medicare Advisory Board will help ensure that payment reforms continue to occur and have a good shot at being implemented.

Clearly, curbing federal health spending will relieve significant pressure on the budget in the years ahead, even after accounting for the expansions in insurance coverage. But will it also reduce the growth rate of costs in the private sector? Our analysis suggests that the so-called “Cadillac tax,” which will be levied only on the most expensive private sector plans, will provide health insurers with a powerful incentive to reduce their premiums and provide a high-value package of benefits. The added benefit is that the resulting reduction in premiums will lead employers to pay substantially higher wages to affected employees, with this effect growing over time, according to estimates by the Congressional Budget Office (CBO) and the Joint Committee on Taxation.

The reforms proposed in Medicare should also be an essential catalyst for delivery system improvements throughout the private sector. Bundling of care, administrative simplification, and other efficiency improvements will likely spread from the Medicare program to the private insurance providers.

The CEA estimates that altogether the Senate health insurance reform bill will slow the growth rate of public and private health care spending by 1.0 percentage point per year or more. Because the reductions occur year after year, what sounds like a small number will have tremendous benefits for the economy, families, and businesses. As a result of this slower cost growth, we project the typical family’s income will be thousands of dollars higher per year by 2030. The degree of slower cost growth that we find will also result in a significantly smaller federal budget deficit in the upcoming decade, with the effects growing over time. Lower health care cost growth will also reduce inflationary pressures, allowing for a period of lower unemployment and higher job creation.

Small businesses and their employees will especially benefit from health care reform. Currently, small businesses pay up to 18 percent more for the same policy as their counterparts at larger firms. Slower cost growth and setting up an insurance exchange where small firms capture some of the buying power of larger firms will result in lower premiums. This in turn would allow small businesses to pay higher wages, hire more workers, and increase investment. It would also increase workers’ incentives to launch their own small businesses.

The legislation making its way through Congress can deliver on its promise to substantially reduce the growth rate of health care costs in both the public and private sector in the years ahead. By passing health care reform, Congress will not only expand coverage and make health insurance more secure for all Americans, it will also help set our economy on the path to reducing budget deficits, increasing incomes, and creating jobs.

http://news.yahoo.com/s/ynews/200912...s/ynews_pl1038

Gibbs on Broken C-SPAN Pledge: Obama Wants to Sign Bill Quickly
By Philip Klein on 1.6.10 @ 1:18PM

Pressed during today's briefing to White House reporters about President Obama's campaign pledge to have health care discussions broadcast on C-SPAN, spokesman Robert Gibbs first dodged the question and then responded by saying, "The president wants to get a bill to his desk as quickly as possible."

Gibbs also referred reporters to the transcript of his remarks on the C-SPAN question yesterday http://www.whitehouse.gov/the-press-...ert-gibbs-1510 , but yesterday's briefing happened before a closed door meeting http://spectator.org/blog/2010/01/06...c-bill-is-abou in which Obama urged Democrats to bypass a formal conference to merge the House and Senate health care bills and negotiate behind closed doors.And at that time, his response was that he hadn't read the letter C-SPAN sent requesting that the meetings be broadcast.

Here's my transcription of Gibbs' exchange on the C-SPAN question:

Q: During the campaign, President Obama on numerous occasions said words to the effect of, quoting one, “all of this will be done on C-SPAN in front of the public.” Do you agree that the President is breaking an explicit campaign promise?

GIBBS: You know Chip, we covered this yesterday and I would refer you to yesterday’s transcript.

Q: (Inaudible) today?

GIBBS: The answer I would give today is similar to the one…

Q: There was an intervening meeting in which it’s been reported that the President, the President pressed the leaders in Congress to take the fast track approach to skip the conference committee. Did he do that?

GIBBS: The President wants to get a bill to his desk as quickly as possible.

Q: In spite of the fact that he promised to do this on C-SPAN?

GIBBS: I would refer you to what we talked about in this room yesterday.

Q: But the President, in this meeting yesterday, pressed for something that’s in direct violation of a promise he made during the campaign.

GIBBS: And I addressed that yesterday.

Q: Well does the President believe it would be more helpful if this process were more transparent, that the American people could see…

GIBBS: How many stories do you think NBC has done on this?

Q: Speaking for myself, hundreds…

GIBBS: Hundreds?

Q: That’s not the issue, the issue is whether he broke an explicit campaign promise.

GIBBS: So the answer is hundreds. Is that correct?

Q: Well that has nothing to do with it. I deal with the information, however much or little of it there is. I’m saying, would people benefit from more information?

GIBBS: Have you lacked information in some of those stories? Do you think you’ve reported stuff that was inaccurate based on the lack of information?

Q: Democrats ran against the very sort of process that is being employed in this health care debate.

GIBBS: We had this discussion yesterday. I answered this yesterday. Is there anything else?

http://spectator.org/blog/2010/01/06...-c-span-pledge

[b]
Why the Senate HC Bill Is About To Get More Expensive
By Philip Klein on 1.6.10 @ 11:26AM

President Obama has given House and Senate leaders the green light to eschew the transparency that comes with a formal conference to merge the chambers' health care bills, and instead have informal closed door talks that will be inaccessible to the media. The clear message is that speed is more important than anything else, including President Obama's campaign pledge to have health care negotiations broadcast on C-SPAN to "enlist the American people in the process." http://www.breitbart.tv/the-c-span-l...e-negotiations This need for speed isn't being driven by a desire to give Americans health care coverage as soon as possible -- those benefits don't kick in until 2014 -- but entirely a result of Obama's own vanity and political calculations, because he wants to be able to sign a bill before his State of the Union Address.

The Associated Press reports http://news.yahoo.com/s/ap/20100106/..._care_overhaul that "the House will work off the Senate's version, amend it and send it back to the Senate for final passage." If so, we can only expect the Senate bill to get more expensive. The reason is that with the public option now likely out of the picture, Speaker Nancy Pelosi will have to find some way to keep her liberal caucus onboard with the health care bill. Remember, the first time around, the health care bill would have been defeated in the House had Pelosi lost just three more votes. Given that a handful of pro-life Democrats would bolt assuming the abortion language is watered down, she cannot afford any more defections among liberal members. That likely means increasing the amount of subsidies offered to individuals to purchase insurance on government exchanges, and perhaps having them start sooner -- both of which would increase the cost of the legislation.

As I've noted on a number of occasions, the CBO cost estimates that get quoted in the media understate the true cost of the health care bills because Democrats have employed a number of accounting gimmicks to get the number they want. While the frequently-quoted number may not be representative of the true cost of the legislation, the White House decided at some point that the number that does get quoted shouldn't be higher than $900 billion. Majority Leader Harry Reid found a formula that enabled the CBO to churn out the number $871 billion as the cost of the final Senate bill. However, the comparable number in the CBO analysis of the House bill was $1.055 trillion (the subsidies alone cost $166 billion more).

So, the question is, what will be the cost of getting liberals to fall in line with a bill that does not include a public option? And what new spin will the White House resort to when the headline number crosses the magic $900 billion threshold?

UPDATE: BreitbartTV compiles 8 clips of Obama promising that health care negotiations will be broadcast on C-SPAN. http://www.breitbart.tv/the-c-span-l...e-negotiations


http://spectator.org/blog/2010/01/06...c-bill-is-abou