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Obamacare Will Lead To A U-Turn On Life-Expectancy: What To Tell The Blue Dogs

Saturday, May 30, 2009  |  posted by Hugh Hewitt

The disorganization among opponents of the “government option”/single payer/rationing that is at the heart of the Obama/Pelosi/Reid proposals to radically restructure health care in America is, well, non-existent. Until a specific proposal is on the table, the big interest groups are holding back, in a classic display of the triumph of hope over experience. When the Pelosi bill finally emerges from the House, even then the ostrich approach will continue as the groups tell themselves that the Senate will save them. [# More #]

But the Senate won’t save them because of the rule change that allows health care restructuring to pass with 50 Democratic votes. If a terrible bill gets out of the House, a terrible bill will get out of the Congress. The e-mail below illustrates –again– that voters have no idea that woeful destruction to the amazing American system of medicine that are on the horizon. But if you are one of those who do get it, look through this list of “Blue Dog Democrats” and contact one or more to urge them to reject “the government option”/single payer/rationing. If a blogger has already come up with a comprehensive post with contact info for the Blue Dogs, especially their office phones in D.C. and their districts as well as e-mails, pleas send along the link or the info. I will have my interns work on the contact list next week as well. I think any even remotely aware consumer of health care services has got to realize that the Democrats are on the verge of a massive destruction of the American medicine delivery system. There are problems in health insurance cost and coverage, but not in the quality of care and the innovation instinct, and the Democrats are going to kill the latter in the fruitless quest for improvements to the former. The “government option” is the biggest threat of all, a thinly digusied lurch to Canada-style single payor with the hidden (and increasingly not-so-hidden) rationing and lousy care that canada provides its people with complex diseases and conditions.

Unless enough Democrats get the message that a vote for Obama/Pelosi/Reid is a marker that will attract enormous political payback in 2010. They won’t believe that unless they hear it from enough people, and hear it in such a way as to believe that their correspondents are serious about contributing to the Blue Dog’s opponent in 2010 and even walking a precinct if necessary. Saving health care has to be for Republicans what killing Social Security reform was for Democrats in 2005 –a line in the sand that, if crossed, will never be forgiven.

It is amazing that neither the D.C. GOP or any of the doctors’ groups have yet organized such an effort, but the Beltway creates and reinforces an insiders’ ethic that enervates otherwise sensible people. But the peril to medicine is real, as the e-mail below indicates. So do something about it.

From Dr. L in Illinois:

Dear Hugh,
As a brief background, I am a board certified medical oncologist in private practice with a 22 physician group in Chicago and the adjacent suburbs. We see patients in ten hospitals, seven offices, and see nearly 5000 new patients per year. I finished training in 1993 and joined my practice that same year. I am a partner and practice manager, responsible for both patient care and ‘nuts and bolts’ financial and organizational management of the practice, along with our other officers.
This weekend, the American Society of Clinical Oncologists will hold their annual meeting in Orlando Florida. While it is directed at the American cancer treatment community, it has become the de facto World cancer meeting. Much of that stems from the plethora of companies based in the US that have brought to the market a multitude of groundbreaking drugs, developed in US academic centers and thereafter applied to the American population at large who suffer from cancer.
Reading the Meeting Proceedings between [visits with] patients in my office (not my turn to go this year), I’ve rarely seen an annual report that held such promise. There are a multitude of both new drugs, and new applications of established drugs that promise to accelerate the 1-2% annual drop in cancer mortality that we’ve seen since the late 90’s. It’s a better time to have cancer than ever before—if, of course there was ever a good time for such misfortune.
Alas, I think many of these advances will be stillborn. And yes, I expect the Obama administration to be the instrument of its destruction.
I will be the first to point out that there is enormous waste in American medical care. There’s plenty of blame to go around; physicians are rarely capable economists, and rarely consider the cost:benefit ration of that extra test or that extra day in the hospital; “Nothing’s too good for my patient” is laudable, but is also a screen behind which too many of my colleagues hide their intransigence. Greed is hardly unknown, though I believe far less widespread among physicians than their various suppliers. I admit to something less than objectivity on this. Medicare guidelines are often the perfect example of the adage “there’s no problem that government can’t make worse and more expensive”.
Despite the fact that perhaps 15% of healthcare expenditures go to physician compensation, it’s the convenient target. Hospitals, private payors and Pharma are very effective in the political arena. The AMA, looked upon by the uninitiated as the’voice of American medicine’ is nothing of the kind. We, frankly haven’t the time, nor often the inclination to participate in the political wrangling; many of the ‘thought leaders’ in medicine are academics, whose goals are often diametrically opposite the more than 80% of physicians who practice in the private, nonuniversity sector.
Every analysis of oncology suggests that we have a 10-30% deficit of trained physicians staring us in the face by 2020. Every academic analysis suggests one or another program, and bemoans the difficulty in attracting qualified medical students and residents to oncology. It’s quite simple, really: very hard work, and declining income. Private practice physicians have seen a fall of approximately 30% since 2004. Worsening economics are right around the corner. Given the extraordinary expense of chemotherapy and supportive therapies, combined with reimbursements that just exceed a wash, it will become impossible to deliver outpatient care in more than half the venues in the United States quite soon. And then, simply put, the senior physicians will quit.
Make no mistake: most of us enjoy the opportunity to do what we do. After all, we cure cancer for a living. Hard to top that on the “Useful Professions” scale.
We also, however endure just the stressors and personal strains that you might imagine. We trade time, and inconvenience, for money. Just like everyone else in the private sector, only more so—after ten years of training after college. With the prospect staring us in the face of working harder than the average internist, and earning less: well, if I were 58, and my kids were grown and my mortgage paid: well, I’d call it a day. At 48, I’m already working on an exit strategy by 55 in anticipation of this scenario.
I could go on, but this note is far too long already. Specialists, and underpaid generalists will hang it up years ahead of their planned exit from medicine in just about any system that the Obama administration is likely to devise. They’ll scarcely need to ration care: there just won’t be anyone around to deliver it. Government will kill the golden goose, and then blame it upon everyone and anyone else. As usual.

Read that again. Then go and call/write/e-mail some Blue Dog Democrats. Tell them to stand up to the left wing of their party or stand down in the next election. Promise to support their opponent if they support the destruction of American medicine.

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“The Foundations of Religious Life”

Friday, May 29, 2009  |  posted by Hugh Hewitt

I began today’s show with a segment featuring Sister Prudence Allen, RSM and Mother Regina Marie Gorman, Carmelite Sisters of the Most Sacred Heart of Los Angeles. I also pretaped an hour with them which will air next Wednesday. The reason for their visit is the publication of a new book, The Foundation of Religious Life: Revisiting the Vision. If you have ever wondered what it is that motivates nuns, how they live in community, or about the nature and scope of the changes have swept through the orders post Vatican II, you will greatly enjoy this book.

Foundations of Religious Life: Revisiting the Vision

North Korea, Iran and the Healthcare Debate

Friday, May 29, 2009  |  posted by Hugh Hewitt

The debate over Judge Sotomayor is fascinating, but also risks diverting conservatives into an ultimately fruitless expenditure of scarce resources in the coming three months.

With a 59-40 split in the Senate, Judge Sotomayor will almost certainly be confirmed, and though some sustained and focused questioning should occur at her hearings (especially on the subject of “superprecedents”), I expect that like Chief Justice Roberts and Justice Alito, she will shine in these hearings because federal appeals court judges are simply much more skilled in such settings than most senators. The controversies surrounding her that have surfaced will, absent some unknown series of revelations, not derail her confirmation, so time and money spent trying to do so is time and money wasted at a crucuial moment in the country’s life.

Abroad we face enormous dangers from the nuclear ambitions of Iran and the nuclear recklessness of North Korea. President Obama seems wholly unconcerned –removed even– from these twin crises, and as my conversations with Mark Steyn, Christopher Hitchens and John Bolton over the past few days demonstrate, this is alarming because the risks from both rogue regimes are so real. I wrote one of my radio colleagues yesterday that Benjamin Netanyahu is the de facto leader of the world’s realists right now, as both President Obama and Prime Minister Brown don’t seem to want to be bothered by these terrorist regimes, as though ignoring them can make them disappear. Conservatives must continually call attention to the fact that America is in fact doing nothing as the menace grows, and outline the sorts of steps that could be taken by President Obama if and when he awakens to the menace.

On health care the opportunities for activism and effectiveness are much more real. President Obama yesterday urged his national political organization to call Congress to press for passage of radical health care restructuring –a demand that his most loyal supporters in turn demand approval of a bill that hasn’t yet been written! The call for blind allegiance to an unwritten bill signals that the Administration has zero interest in anything other than a political triumph, no matter the cost or effect on the amazing health care system the U.S. currently enjoys. This attitude –political wins over everything else– has defined the first four months of the Obama Administration and will continue to dominate it unless and until Republicans and responsible Democrats join together to stop the sudden, hard left lurch of the Obama agenda.

That has to happen on health care, and it means identifying and lobbying the 50 or so House Democrats and the 10 key Democratic senators who are most likely to oppose the “government option”/single payer meltdown that looms. Why no such list of the Democrats on whom most of the attention must be focused has yet been developed is amazing, but hopefully it will emerge soon.

In the meantime, I continue to request that doctors who see what is coming if the Obama/Pelosi/Reid rationing plan advances send me their analysis at for posting here as appropriate (with or without names as requested), and for everyone to research the most moderate Democratic House members in their states and contact their offices to urge that American health care not be endangered by the radical rewrite being pushed by the president.

“Free Our Healthcare Now!” Petition

Thursday, May 28, 2009  |  posted by Hugh Hewitt

President Obama took to the phone from Air Force One today to urge pressure on Congress to pass an as-yet-unwritten bill.

Push back via this petition. Send the link to 10 friends.

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