Sane Perspectives on Healthcare

Watch Rep. Paul Ryan making sense, and clearly confusing Rep. Louise Slaughter:


Meanwhile, I wanted to share this, with a Hat Tip to Deacon Greg Kandra. He posted an excerpt from Cardinal Seans thoughtful musings on healthcare, and then tipped me off to this comment from one of his readers -although I have seen it on several sites, today, so I am not sure where it originated- which I am reprinting in full, because it is sane and sensible:

I have been a doctor for 19 years. 4 years in the Army and 15 years in private practice. I belong to a doctor owned group of approx 350 doctors in a multi-specialty practice. We employ 4000 people. In addition to being touted as one of the very best clinics in the nation (Acclaim Award winners) we have donated over a million dollars to the local city in grants, scholarships and charity. Regularly voted as top places to work by our employees. US healthcare at its very best. I am very proud of what we do and we provide tremendous care and value to our patients.

We seek to maintain a 3-5% profit margin annually. We operate in the very precarious business model of enormous volume, low margin. As any business owner knows, this is high-risk-low-margin of error model. Consequently any small changes to cash flow vectors, mandates widespread internal policy and practice corrections. Tiny changes = massive consequences.

As many people may know, Medicare and Medicaid, the current government paid ‘insurer’ – pays approximately 70% of the cost of care. ie its more expensive for doctors to care for these patients than we get reimbursed for. Say you are a contractor. Imagine the government mandating a significant number of your jobs whereby your out of pocket costs are ~ 30% + greater than your income. That is Medicare and Medicaid. In perspective, our group alone, year 2008 lost ~$12 million caring for our government patients. This is despite taking over 1 1/2 years to help move our fee-for-service traditional Medicare patients over to Medicare Advantage plans, which are privatized versions of Medicare that reimburse better…still not covering costs…but lessen our losses significantly.

Many people ask, why do private health insurance premiums continue to escalate? The liberals want you to believe its a combination of profiteering and waste. When in fact its due mainly to two other processes. The first is obvious: every year it costs more to care for patients and premiums are trying to keep up with this rising cost. But secondly, and less often discussed, is that every year private delivery systems lose more and more money caring for our government patients. Someone has to make up for these losses in order for your hospitals, clinics, nursing homes, pharmacies, group practices to remain solvent and profitable. Every year these delivery systems open their books to the private healthcare insurers – and the insurers must – they must in order for the entire system at large to stay functional, increase the amount they pay out to cover these losses. If they dont, both the delivery systems and the insurers die. So to keep the boat afloat, the payouts by private insurers MUST increase to subsidize the ever increasing losses doctors incur by taking care of our government patients. So, in a way, you could say that your increasing premiums are a tax that you are paying to cover the losses that are Medicare and Medicaid. It’s a clear and inarguable private subsidation of government cost. Enough said on that.

So to really feel the consequence and full impact of Obamacare, one must simply see the economic dominos. Most people can see how this bill will rapidly reduce private insurance plans and rapidly expand government plan patients. And take whatever number that is being reported, and multiply that by 3. That has been the experience in both Mass and Hawaii. Both government plans were overwhelmed with the enrollees as they significantly underestimated the government migration.

Ok, so now- how can anyone not see the obvious outcome? Government patients = significant loss of profitability. Initially the private insurers will do their best to continue to subsidize this loss, and there will be a huge escalation of premiums. But within a few months this will be unsustainable. Its a cycle that cannot be stopped. Higher premiums = higher recidivism to government plans = higher premiums etc. Within months, every single hospital, every single doctor office, clinic, nursing home, pharmacy – every delivery system reliant on private insurers will no longer be profitable. ie they will go bankrupt. These will most certainly be the headlines to come: Hospital XYZ shockingly announces bankruptcy; Hospitals can no longer remain open; Clinics across the country file for bankruptcy; Loss of Pharmacy access shocks the Nation; Doctors going bankrupt en masse creating healthcare delivery and access to care crises; Where can you go to get care?; Loss of access reported Nationwide

Yes a crises. A crises of access due to widespread business failure. You will not be able to get care for as long as it takes for the government to devise their emergency bailout package and as long as it takes for those insufficient dollars to try and get those doors back open again. But it will be too late, and it will be too expensive. There is absolutely no way that our government can capitalize our entire healthcare system. Try as they might, only a percentage of what we have now will ultimately survive. And those that do survive will be a shell of what they once were. The conditions will be frightening, and the consequences will be dire. The degree of disarray will be unimaginable and the underlap in access to care will be gaping.

I will not expand this discussion to predict what this means to our economy at large because I am not an economist. But anyone can be close to predicting what I am suggesting. Factors such as loss of work hours due to illnesses not treated, pressure on all the other private business models; let alone the out and out loss of enormous capital via the bankruptcy of this entire healthcare industry can clearly be the death nail to our country and imo is a clear and present threat to our very sovereignty. This can make the housing collapse look like a speed bump. This will be massive and rapid and lethal and complete.

I am not certain why this very obvious outcome has not been openly discussed more often – ie the rapid and massive bankruptcy of all of your health care providers and their delivery systems. But this is the inevitable outcome should this bill ever become law and implemented.

Thanks for reading. Please ping, copy and email your friends and try and get this word out. I know it’s a very late hour – but I do think the implementation is not an inevitability as multiple lawsuits may keep it on hold for a while – so public opinion will still be vital for many more months to come.

Unbelievable times. Please do your part and email and make the phone calls. This plea comes an honest and heartfelt love of our country and its citizens, and an honest and heartfelt love of my profession, avocation and the welfare of my patients.

Send this around to everyone you know. Read it to your neighbors. I’m filing it under “critical thinking.” Check back for updates:

Althouse is posting Meade-taken-Pics from the capital protest. Meade is very cute, but this is my fave:


Apparently “deem and pass” is dead. I think a buncha people marching on DC may have something to do with that. Or, Pelosi has the votes to pass.

Why Obamacare Would Fail
Nationwide Protests
The Fine Print Does Not Square with Obama’s Rhetoric

About Elizabeth Scalia
  • AB

    Question: If this passes why won’t the private doctors cut-loose the government patients, i.e. see only those with private insurance? Given that they are loosing 30% on these patients, why has this not been done already?

  • Copper Quark

    It is done in certain places and circumstances already. For example, last week the Walgreens in Washington state announced that they would take no new Medicaid customers. So far, they have elected to keep those they have, but they are not accepting any new customers.

  • mrp

    I saw that pic at Althouse’s site. I hope the attendee takes good care of that historical artifact – for now the whole world can see how Uncle Joe might have looked with a shaved lip and a botoxed facelift.

  • Gerry
  • http://!!!! kelleybee

    That kind of collapse is exactly what those who got Obama into office (Soros, and the other useful idiots) want to happen — Alinsky rules in action.

  • nan

    Just copied and e-mailed this to Dan Maffei – our local congressman who has indicated he will vote yes. Thank you for posting this.

  • Bender

    Apparently “deem and pass” is dead.

    Well, I’m glad that America dodged this particular bullet, but I can hardly thank the Dems for not doing what they should never have even contemplated doing. And even so, don’t think that with this crowd that anything is ever dead dead. Mostly dead maybe, but not dead dead. It’s a demon after all.

  • Bender

    “Building on Democrats’ momentum, House leaders decided on a straight up-or-down vote on Obama’s top priority and the defining issue of his first year in office

    So, what? They are going to do what just the other day they voted against doing?

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  • Maureen

    Private doctors may ‘cut loose’ these patients, but it will not take long for the government to close that loop hole. In the early 60′s that was the promise in Canada, but it soon morphed into a system where the only options that doctors have is to not take any new patients. Every year the various provincial governments ‘negotiate’ fees for doctor services – and none of those fees ever actually cover the costs unless the doctor is seeing 50/60 patients a day. So technically doctors in Canada are not employees of the government, but the government decides what they will be paid for what services and they are prohibited from charging ‘extra’.

    Any money that goes into the health care system quickly gets eaten up by raises to union workers with the continual demand that we can’t recruit nurses, techs, etc unless we pay them more – so more money is pushed into the system and the only thing that changes is that nurses earn more. I like nurses, but a nurse that chooses to be a casual nurse should not be earning $85,000 a year!!!

    US – welcome to the Canadian health care system. Phoned my family doctor on Friday to book my annual physical (for which she will get paid $41) – the earliest appointment she had available was late June – 3.5 months away.

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  • sofa

    “Success” for Dems is in the destruction of the best medical care in the world, theft of 1/6th of the economy, and the enslavement of the people.

    Health care of citizens is not the measure.
    Why even bring it up?

  • AB


    I know that in some socialized systems it helps to bring a little something for the doctor. Are envelope’s full of cash required is some places in Canada, or in some specialties?

  • Diane

    I live in the district Louise Slaughter claims to represent. I’ve lived here since a few years before she moved here from Kentucky. I honestly don’t know how she keeps getting reelected. There are no strong conservative candidates willing to go up against her; politics in NY is about as dirty as I’ve seen anywhere else. From time to time I run into her locally, she oozes condescension. I’ve tried to talk to her about various issues; as soon as she gets the sense that one has an opposing view, she “dismisses” the person and walks away.

    I’d like to apologize to the entire country for this person.

  • Barbara

    Slaughter et al don’t know doctors are collecting a tax from everyone they have to overcharge because they’re not being reimbursed at 100% of their costs for the Medicare and Medicaid patients?
    We give to the poor and sick as Christians – it shouldn’t be extorted from us. The Dems are being dishonest, or is it delusional?
    Everyone that can, please do a Holy Hour or two tonight to pray for members of Congress.

  • Fr. William J Kuchinsky

    Just in case it’s not clear, the USCCB issued a statement Sat, 20 March. The last paragraph:
    “With deep regret, but clear in our moral judgment, we are compelled to continue to urge House members to oppose the Senate bill unless these fundamental flaws are remedied. At this critical moment, we urge Representatives to take the steps necessary to ensure that health care reform respects the life and dignity of all, from conception to natural death.”

  • Tempus_Fugit

    All this because a sizable chunk of the US thinks they’re in for a government freebie.

  • cathyf

    Here’s a little one for you…

    A small part of the bill is a medicare tax on “unearned” income — things such as investment returns, rents, etc. At some point in the last week it seems to have gone from 2.9% to 3.9%, but nobody really knows because the bill is constantly shifting.

    If there is a tax on rental income, in this current economy, landlords will not be able to pass on the tax, which means that their income will go down. Now the market value of rental property is simply the net present value of the expected future stream of income from the property. So this tax will cause of direct hit to the market value of every piece of rental property in the US.

    For every piece of commercial property with a mortgage, the bank will need to write down the value of their loan to reflect the new market value. You think “too big to fail” was big? This is orders of magnitude larger. Not just a few giant investment banks like the 2008 crisis, this affects every bank on out there. Writing down all of those loans will cause virtually every bank in the US to fail.

    And that’s just a little side-effect of the bill, that doesn’t have anything to do with health care.

  • Roz Smith

    Here’s an example of one of those hidden subsidies. Last September I had to transfer my mother from the assisted living facility she had been in since 2003 to the Alzheimer’s wing of a nursing home. When the bill for the second and third month showed a significantly lower daily rate, like some 20% lower by the third month, I wrote a letter to ask why the drop in rates as I knew that the level of care Mom needed had not changed. I was told that the State of Minnesota mandated that nursing homes charge their private pay patients a surcharge for the first month in the facility.

    When the state mandates I pay more I call it a tax. That it was paid directly to the nursing home and not the state does hide the fact that the purpose was to cover the fact that nursing homes lose money on Medicaid patients.

    Both the dishonest name and the fact that it was buried in the daily rate and not separately stated really irked me. If Mom had passed during that first month instead of lingering on to December, I never would have known about this nursing home tax.

  • Linus

    I watched much of the House Rules Comittee hearings Saturday. I was highly impressed by the intellectual level and clarity of the Republican arguments and the lies and ideological follderal of the Dems. Dems who believe they can trust the promises of Harry Reid and his gang and the Pres. are whistling in the dark. We have had nothing but lies from them since the election. Why the Bishops attempted to work with this gang and Pelosi and her crowd is a mystery. And a pox on those religious who were so gullible. How can we ever trust them again? And did you know they are still supporting ” climate change ” legislation!! It is hard to believe.

  • Elaine S.

    “I’d like to apologize to the entire country for this person.”

    As an Illinois resident I’d like to apologize to the entire country for having inflicted this president on you (even though I never voted for him, ever). If it hadn’t been for our pathetic, desperate and scandal-ridden joke of a GOP, we might have kept Obama from winning the Senate seat on ’04 and none of this would be happening.

    Until the last few days I had a hard time believing that any politician could bring us more shame and embarrassment than Governor Hairdo (who’s going to be on ‘Celebrity Apprentice’ again tonight, by the way). I never thought it possible Obama, Rahm, and Axelrod make me feel even more ashamed than ever to be from Illinois. I suspect I’ll get a few extra decades in purgatory just for that.

  • John Brown, Harpers Ferry, WV

    This is bigger than slavery. Once you take a life, you can never manumit.

  • Maureen

    AB – I haven ‘t heard of any but you can move forward in the various line-up by who you know and who your family doctor knows. I finally got back surgery after showing up almost every day in my family doctor’s office crying hysterically – she talked to a family member who is a surgeon and he slipped me in. The sad part is that I’m sure there were others who were in more pain for longer, but were just not willing to humiliate themselves as I was ( I was in extreme pain)

    It also helps if how you were hurt – for example if you have a workers’ compensation claim, they will send you out of province for service rather than have you remain off work waiting for service in your home province.

    And then again, if you are wealthy you just go to the US – like Premier Williams. But that option could disappear depending on how Obamacare pans out.

  • TeaPot562

    Unless you are in the district of an “on the fence” congressperson, your only recourse at the moment is prayer.

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  • Anthony

    How about this for a sane perspective on healthcare. I opposed the bill for fiscal and philisophical reasons.

    But we are talking about a fiscal and government boondoggle, not the Enabling Act here.

  • Joe

    Who do we blame for last night? Well George W. Bush, of course:

    The question conservatives should be asking though, is how did we get in this position in the first place? How come, over the course of two elections, Democrats were able to take back the White House and amass substantial majorities in both chambers of Congress, allowing them to enact this sweeping legislation with no Republican votes – and huge defections in their own party? How could a generally right-of-center nation be taken over by liberals from Chicago and San Francisco?
    The answer, of course, is that none of this would have been possible without George W. Bush — or more broadly speaking, Bush era Republicanism. While they were in power, Republicans squandered an opportunity to push free market health care solutions. When they did use their power to pass major legislation, it was for policies like the big government Medicare prescription drug plan, which was (until today) the largest expansion of entitlements since the Great Society. They took earmarks and doled out farm and energy subsidies. They earned a reputation for fiscal recklessness and corruption and incompetent governance. President Obama ultimately forced through the health care bill in spite of the political consequences to his party because he’s ultimately a true believing liberal. But it was only because of the failures of Bush-era Republicanism that an ideological liberal with little experience was able to capture the presidency on the abstract notion of change.
    Today will be largely remembered as the biggest legislative victory for liberals since Medicare in 1965. But it should also be remembered as the day that Bush cemented his legacy as one of the most destructive presidents for advocates of limited government.