DoctoRx Comments on the President's Healthcare Speech and Goes Where Few Politicians Have Gone Before

The President has addressed Congress and the American people on health care reform; click HERE for the text of his speech. Also, you may click to see the Republican response (given by a heart surgeon).

One thought I have is on the following quote from the speech:

The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing to improve your care. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.

Fraud and waste are not easy to eliminate, and "waste" is not even easy to define. These should be addressed ASAP and need not be part of sweeping health care reform. Medicare's famously low overhead administrative costs are part and parcel of not requiring pre-approval for tests or alleged surgeries, thus allowing fraud to exist on a significant scale. In my part of the country, Miami, Medicare fraud is a major industry. Eliminating it would put a lot of people on the dole!

So far as reducing subsidies to managed care companies: go for it! But once again, legislation on that issue could already have passed Congress. Despite being thwarted on broad healthcare reform, President Clinton moved successfully against Medicare HMOs, saving the taxpayer muchos dineros. Medicare HMOs are parasitic creatures, as are essentially all HMOs. If they are really so efficient, let them prove it by asking for no subsidy.

Regarding "preventive care": This term is often misused. A mammogram is a form of cancer screening; an abnormal mammogram is not designed to prevent cancer but rather to catch it early. In any case, I believe that early detection of cancer, diabetes, high blood pressure, etc., is a very good thing; but I also believe that it is expensive. Long ago, it was taught that long-term treatment of mild high blood pressure added but one year to a person's expected life span. Is this a good thing? Yes. Does it cost more money than it saves? Presumably, yes. I do not believe that the President has been accurately advised when he insists that preventive care is, say, revenue-neutral. I for one would much rather see my government have spent money on preventive health care than huge sums saving stockholders and bondholders of giant financial conglomerates from losses, but you can't always get what you want, and the good things that this President wants to do for the uninsured simply cost money. One reason for skepticism of his plan in certain quarters is the recollection that Medicare was supposed to cost small potatoes when it was created. Whoops!

Whether it's a social program or a war in the Middle East, people remember who promised wrongly at the outset, no matter whether or not the promise was made in good faith.

Now to the main event. Believe it or not, there are more important health care fish to fry than fiddling with insurance plans. Here goes:

The single most important thing that the Administration can do right now in the field of health is to create, support and enhance programs to combat the obesity and overweight problem in this country. The next most important thing is to stamp out cigarette smoking. Perhaps the President will lead the way in that regard. Mr. Obama should use the bully pulpit to aggressively promote health habits that will actually prevent heart disease, smoking-related cancer and lung disease, and the like. If he wants to really get with the DoctoRx program, the President will promote vegetarianism (or modified forms thereof) as part of a program both to achieve/maintain good health and to promote environmental greenness.

None of these initiatives requires a 4-year waiting period. There are numerous specific things that can be done by executive order, legislatively, and rhetorically to fight the good fight to get the pot bellies off Americans, prevent children from growing big bellies, and make cigarettes obsolete.

Those are just some initial goals. What about even tougher laws against drunk driving? What about persuading Hollywood to present getting drunk as unfunny and worse? Etc. and so on.

Where all sides in this debate have missed the main point is that a large portion of the ills that American flesh is now heir to are preventable by life-style improvements that cost both the individuals and the taxpayer less than nothing, but rather pay for themselves financially many times over. Can this unhealthy society change?

Yes. It. Can.

But. It's. Not. Easy.

Fitness first.

Copyright (C) Long Lake LLC 2009

The Administration Says: Please Buy a New Car But Leave Home Without It

The Administration is all over the auto industry these days. On the one hand, there is immense effort to deal with the miserable condition of GM and Chrysler. The government is in charge and will have its way, one way or another, with all the other parties trying to game the system as best as they can.

On another related front, one of the centerpieces of the stimulus program was an enhanced roads program. We recall VP Biden proudly standing in Michigan touting the alacrity with which a 4-lane roadway was being transformed into one with 6 lanes.

And many of us remember Dr. Christina Romer on Meet the Press 6 weeks ago saying the following:

I think we know that consumers have lost a lot of wealth and that normally what you'd say is they should be saving more. I think the truth is consumers have also not done a lot of spending for the last 14 months. So what I would predict and I think would be a perfectly reasonable thing is you go out and you buy that car that you've been thinking about for 14 months and you do some of the spending.

So Barack Obama is strongly in favor of keeping lots of people busy building autos, making driving hassle-free, and of course busy adding another vehicle to the roads.

There is however a great big green BUT . . .

Barack Obama personally has informed us that we must reduce our carbon emissions. Being green means to the administration that every human exhalation is contributing to the rising of the seas. Therefore, every time anyone drives a vehicle anywhere, some grains of sand on a beach are being murdered as the oceans rise in response.

The U. S. contains about 9 motorized vehicles for every ten Americans. The green solution is to reduce that ratio substantially. The politically expedient solution is for taxpayers to keep subsidizing all of the following: auto manufacturers, the pensions of the UAW, the providers of financing to purchasers or lessees of the vehicles, and the maintenance and expansion of the roadways. Not to forget that taxpayers are going to subsidize improvements on the internal combusion engine.

Houston, we have a contradiction. An important part of Federal policy is to support the auto industry as we know it. Please don't use the end product, though, because when you do, you are an environmental villain.

We have other contradictions. Since this is a President who is emphasizing personal responsibility, what about him ending his addiction to cigarettes? Every time he lights up, he is adding to the global burden of carbon in the air. In addition, he is supporting some of the worst of the worst corporate offenders. He is adding a health care burden on society. He is setting a horrible example for American teenagers. Etc.

Cumulatively, if 60 million Americans smoke an average of 20 cigarettes a day, is that not as meaningful from an environmental + health point of view than the recent Administration goal of taking $100 M out of Federal expenditures is to a $3+ trillion budget?

Mr. President, put out that butt! (Please)

Copyright (C) Long Lake LLC 2009