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The Rush To Rationing, Cont.

Wednesday, May 6, 2009  |  posted by Hugh Hewitt

From Doc R.:

Hugh,
I listen to your show on pod cast, so I was unable to comment last night. An issue which you did not mention, but is critical to the situation is the accelerating doctor shortage. I am a senior physician executive who spent 31 years in the Air Force and completed my career as commander at ______ Medical Center….I am currently Sr. VP for Medical Affairs at a small hospital system in ___.
The major problem with every effort to “fix” health care is that they focus on controlling the price that the consumer pays. No one ever takes into consideration the cost of producing that care. This will have a major and increasing impact on the way forward.
Currently, the US is short of physicians and is not producing them at a rate of replacement. Add to that the fact that a 30 year old physician is a completely different animal than a 50 year old physician. Most “old” physicians came into the profession at the time it was considered a calling. Yes, they were compensated (monetarily and otherwise) very well. But for that, they accepted 100 hour work weeks and being on call for months at a time. It was part of the social contract and they just accepted it as part of the life of a physician.
The current crop of physicians do not have the same work ethic. Similar to other members of their generation, these docs expect to “have a life.” They are unwilling to work the same hours as their elders – at any price. Additionally, 50% of most medical school graduates are women who statistically have a much shorter career. You can see that every time one of the old guys retires, you need more than one new graduate to cover the load.
The proposed changes that are ahead will undoubtedly encourage many of the old docs that there is no point in working beyond the point that they can retire. Yes, the fact that many of them have been hurt badly in the crash will keep some at work. But not a day longer than they have to. Then it will be harder for all of us to find a physician to take care of us.
Rationing is on its way.
Dr. R.
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The Rush To Rationing, Cont.

Wednesday, May 6, 2009  |  posted by Hugh Hewitt

Yesterday I posted on the rush to pass a radical restructuring of American medicine that will result in health care rationing as surely as day follows night.

On yesterday’s program Politico’s Mike Allen confirmed that the negotiations are ongoing and very secretive, as the Democrats intend to avoid the mistakes of the HillaryCare fiasco of 1993-4. Mike acknowledged what everyone who follows the subject kbnows –the Obama Adminstration is aiming for single payer by another name and introduced slowly rather than suddenly. In today’s Playbook, Allen reports that Frank Luntz has warned the GOP that “reform” is popular, and that they can’t be caught opposing health care reform. Luntz is righr, which is why the GOP must define the debate in true terms rather than get sucked in to the idea that the Obama plan is “reform.”

President Obama’s “Health Care Reform” = Single Payer = Rationing of Health Care.

No fair minded observer can dispute that,or the experience of Canada or other single-payer systems. Republkicans do indeed have to be for “reform that doesn’t morph into rationing.”

Perhaps the country wants to go to single payer and the rationing it guarantees, but I doubt it. Which is why the MSM is simply not reporting on the negotiations and the direction in which they are headed with any sort of depth or with the detail that would ordinarily accompany such a major shift in American life. The Hill leaks and leaks, but not on this subject, or at least those leaks aren’t making their way to the front pages. The AARP, AMA, Big Insurance and Big Pharma are also incredibly quiet, hoping perhaps to cut a better deal or waiting until they have a target. Allen suggests the Chamber of Commerce is at the table, busy off-loading the cost of insurance on to the taxpayer, which will help their bottom lines but which will leave the quality of medical care in America rolling down a very steep slope.

The anti-single payer groups underestimate the speed with which this “compromise” will move once it is unveiled, and the willingness of the MSM to cover for their most favorite president ever. If rationing is going to be defeated, the effort to explain to the American people what this package means and which Democrats are supporting rationing has to begin yesterday.

The Weakened Immune System of Newspapers

Wednesday, May 6, 2009  |  posted by Hugh Hewitt

Looks like the Boston Globe will live to fight another day. Excellent news. I love newspapers. Really, I do. The Globe was meat and grog to me through my years in Boston, and the combo of Ray Fitzgerald and Peter Gammons may have been the best one-two punch in all of sports journalism in those years. The paper still has some excellent reporters and columnists, among them the estimable Jeff Jacoby.

But Jacoby goes a little Jon Lovitz this AM in arguing that liberal bias in the newspaper world has nothing to do with the ongoing collapse of the business. Key graphs:

But if liberal media bias is the explanation, why are undeniably left-of-center papers like the Globe, The New York Times, and the San Francisco Chronicle attracting more readers than ever when visitors to their websites are taken into account? How does liberal bias explain the shutdown of Denver’s more conservative Rocky Mountain News, but not the more liberal Denver Post? How does it explain the collapse of newspapers in lefty enclaves like Seattle and San Francisco? How does it explain why the great majority of Americans – 60 percent, according to a recent CBS/New York Times poll – get most of their news from TV?

Newspapers are in extremis not because of their political agenda, but because the world around them has been transformed. The growth of the Internet has left the traditional newspaper business model, with its vast physical plant and expensive armies of writers, editors, photographers, pressmen, mailers, truck drivers, and salesmen, in a shambles. Craigslist and its ilk have vaporized what used to be most papers’ greatest profit center: classified advertising. A decades-long trend of falling readership, brought on by the rise of television, has been accelerated to warp speed by the explosion of websites and blogs offering news and opinion on every conceivable subject, 24 hours a day – and usually for free.

The culture has changed. Only 15 percent of Americans younger than 40 now read a printed newspaper every day. It isn’t political bias that keeps them away. Conservatives who insist otherwise do themselves no favors.

Read the whole thing, but really, who is Jeff trying to kid? I have never argued that newspapers are collapsing solely or even primarily because of liberal bias. I have argued and will always argue that just as a patient with a compromised immune system is susceptible to dying when illness strikes, so too have newspapers spent decades shedding hard core readers from the center to the right on the political spectrum, readers who, had they stuck around, would have helped buy papers more time to transition to the new world. That tens of thousands of newspaper readers have canceled because of left-wing bias is undeniably true because Jeff and I both receive the hundreds and thousands of e-mails each year blasting media bias that at times is so absurd as to be ridiculous. Those people have left the field and won’t be coming back. Jeff bemoans young people not reading newspapers? He’s right, but of the fewer and fewer that do, no sane young conservative would spend his few nickels a day on the Globe. He or she would pay for an online subscription to the Wall Street Journal. The number of eyeballs may be up as Jeff says, but the paying customers are way down, and advertisers know this and leave the sinking ship. The Rocky Mountain News is a counter-example? It was just a bit to the right of the Post, not a full throated center-right alternative, and its demise signifies nothing about ideological diversity helping or hurting papers.

Three decades of monolithic newsrooms full of lefties agreeing with each other and a token conservative columnist does not a compelling product make. The changes in information technology and the rise of the web would surely have taken out any number of papers even if all of them had been objective, lively, ideologically diverse offerings where quality reporting appeared alongside informed and entertaining polemic.

But far fewer will survive because very few even tied to be fair. Even now they aren’t trying. The most popular conservative writer today in America is Mark Steyn, bar none. He lives in New Hampshire. When was the last time the Globe carried Steyn?

Really, it isn’t that hard to make a paper entertaining and attract center-right readers. But even as the ships take on water, the captains refuse to do anything to save the fleet.

Journalists who insist otherwise do themselves no favors.

The Rush To Ration Medical Care

Tuesday, May 5, 2009  |  posted by Hugh Hewitt

From one of the trades:

On April 20, 2009, Senators Edward M. Kennedy (D-Mass.), chairman of the Senate Health, Education, Labor, and Pensions Committee, and Max Baucus (D-Mont.), chairman of the Senate Finance Committee, sent a letter to President Obama laying out their commitment to mark-up comprehensive health care reform legislation by early June. The senators’ joint letter expressed an intention to take a shared approach to health care reform legislation, so that the measures the committees report can be quickly merged into a single bill for consideration by the full Senate. “We have a moral duty to ensure that every American can get quality health care. We must act to contain the growth of health care costs to ensure our economic stability; to help American businesses deal with the health care challenge; and to make sure we are getting our money’s worth,” the senators wrote.

Politico has the details on the timing of the jam-down:

Senate Democrats already are holding hearings and hammering out legislative language expected to be introduced in June. A tentative timetable sets floor debate and votes for late July or August.

The House, with its oversized Democratic majority, would follow the Senate action, setting the stage for conference committee negotiations by the end of the year.

Americans are going to go off on vacation and come back to a completely made-over health care system that will ration services and interpose the government between the doctor and the patient. Incredibly, MSM is almost wholly silent on the details of the radical restructuring of American medicine. Reporters know all of the slogans and none of the details, and they haven’t been pushing for answers.

The pro-rationing propaganda machine is in full swing:

[Senator] Baucus is not the only one interested in keeping options open. The senator joined the Center for American Progress on Monday to announce the re-formation of Doctors for America, a grassroots organization of over 11,000 doctors in support of health care reform. Formerly known as Doctors for Obama, the group during the 2008 campaign advocated Barack Obama’s proposal for a government-managed option.

So, “Doctors for Obama” became “Doctors for America,” and it supports “a government-managed option.” What a surprise. There are about 800,000 doctors in the US, so the 11,000 Obama docs are less than 1.5% of docs. Where’s the AMA?

As I wrote on Monday, the silence from AARP is deafening as its core constituency gets pushed closer and closer to a rationing system that will deny them treatment first.

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