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

F As In Fat

Please click HERE to read the article listed in this post's title.

Comment: Less is more. This goes for food once malnutrition is taken care of. It also can go for things such as availability of capital. If less were available, more care would be taken with it.

Copyright (C) Long Lake LLC 2009

14 TRILLION . . . CALORIES

When financially-oriented souls think of the number 14 trillion, they usually think of U. S. GDP. They may also with good reason think of it as the stated Federal deficit plus the amount pledged to support what's left of the financial system.

However, another estimate of the importance of 14 trillion is the number of calories Americans would need to shed in order to get to some semblance of normal weight.

This number can be estimated as follows. 300 M Americans X 15 lbs overweight (or more) X 3500 calories/pound gets one there, plus a little for good measure.

What does this number have to do with an economics post?

Think of the outperformance of McDonald's vs. Wal-Mart. McDonald's stock is the best performer of the Dow 30 over the past 24 months, having returned about 10% in that time frame. Wal-Mart sells what are arguably more necessary items than MCD, yet its stock price keeps eroding. Today, MCD got a lift because an analyst touted the rollout of its premium espresso/cappuccino line.

It would seem that despite a poor economy, Americans are more hooked on junk food and sugary coffee drinks than on the low-margined necessities that Wal-Mart sells.


Copyright (C) Long Lake LLC 2009