The 85% solution

One good thing in the Democratic proposal is a limit on how much private insurers can spend on items, other than coverage costs (Albany Times Union):

[Private insurers] " ... would be required to spend 85 percent of their income from premiums on coverage, effectively limiting their ability to advertise or pay bonuses. Additionally, the industry would be stripped of immunity from antitrust regulations covering price fixing, bid rigging and market allocation. And in a late addition to the bill, 30-year-old restrictions on the Federal Trade Commission's ability to look into the insurance industry would be erased."

This is similar to idea in my proposal to limit profits and may have the same net effect. Let's watch and see if the insurance lobby can knock that provision out. I hope not.

Let's party like it's 1990 (pages)

The NY Times has the poop on the recently released Democratic health care reform proposal. If you could read a page every minute, it would take you 1 day, 9 hours and 10 minutes, just to read the document once. It's so massive, it may need a C-Section to be delivered.

Would Red States opt out of the public option? (NY Times)

Floyd Norris says no

But then again, conservative Governors have done crazier things in the past, in the name of political expediency. Think about who we're talking about here. Bobby Jindal (R-LA)? Haley Barbour (R-MS)? Rick Perry (R-TX)?

The good news is that Senator Harry Reid (D-NV) has got his mojo back and has put the public option back into the still "top secret" health care reform package. The bad news is that Senator Olympia Snow (R-ME) has opted out from voting for the proposal.

American Hospital Association offers malpractice reform idea

It's not much of an idea and in my opinion, by itself will save nothing and maybe even add additional costs. AHA is suggesting a pilot program of health care panels to mediate differences between supposedly injured patients and health care providers. These panels would oversee an Administrative Compensation System (ACS). Although the concept is good, it does not represent forceful action on the malpractice crisis, but it is rather just another "study". These mediation panels have proven to be unwieldy when previously tested by various states. The trial lawyers hate the AHA proposal and physician panels members have found the panels to be more of a debating club that rarely recognizes true medical malpractice. Honestly, in most US malpractice cases, health care providers generally prevail anyway. This panel system could make it even easier for patients to "win the lottery" and get their big settlement. The whole ACS is a pet project of Michelle Mello, a Professor of Law and Public Health at Harvard University. I suggest that the good Professor spend some time practicing medicine and then decide what would be a good solution to the malpractice problem.

Here's also an AP Wire story about the AHA proposal. In my opinion,the AHA proposal does not do enough to reduce costs caused by defensive medicine and is just being proposed to appease opponents of the present health care reform package. This Obamacare proposal does nothing about the malpractice issue and  in general, will do very little to contain costs. Health care should not be a growth industry.

What does Obama's doctor think about health care reform?

This isn't exactly a new item (from Forbes in June of this year), but it points out a couple of reasons why the Government often takes the wrong approach to solving problems. The article is about David Scheiner, an internist based in the Chicago, who took care of Obama from 1987 until he became President. Here's a good passage about Scheiner's view of why Obama has gotten most of the solutions to the health care problem wrong:

Looking at Obama's team of health advisers, Scheiner doesn't see anyone who's actually in the trenches. "I have a suspicion they pick people from the top echelon of medicine, people who write about it but haven't been struggling in it," he says. Scheiner is critical of Obama's pick for Health and Human Services secretary--Kansas Gov. Kathleen Sebelius, who used to work as the chief lobbyist for her state's trial lawyers association. "He doesn't see all the pain, it's so tragic out here," he says. "Obama's wonderful, but on this one I'm not sure if he's getting the right input."

As someone who is also "in the trenches", I can certainly relate to Dr. Scheiner's positions.

PriceWaterhouseCoopers Evaluation of Obamacare

Not pretty. The report, commissioned for the America's Health Insurance Plans (AHIP)  says the cost estimates associated with the proposed health care reform package, provided by the Congress, are vastly underestimated. The White House and the Congressional majority has attacked the AHIP report as flawed.  Get it here.

Physician makes more money on eBay than by practicing medicine.

CNN has a story today about Dr. Jennifer Lickteig, a family practitioner from Iowa, who makes more money selling clothing on eBay than she does from her practice income. A telltale quote from the article:

"Medicine still has its rewards for Lickteig. But like many doctors, she's frustrated that insurance companies and malpractice lawyers have so much influence on the practice of medicine."

As baby boomers retire en masse from practicing medicine and more and more primary care doctors follow suite, the remaining physician pool in the US will consist of high-paid specialists, poorly trained dregs and a few altruistic souls, who still believe that the point of the profession is to help humanity.

Fear of Lawsuits Drives up the Cost of US Healthcare (NPR)

NPR has this piece on long term studies in Maine that show that in geographic regions where health care was more readily available, patients took advantage of more procedures. The studies show that physician and patient behavior both contributed to this excess of health care services and costs, but that the main reason that doctors gave for "excess care" was defensive medicine, caused by the fear of frivolous lawsuits.

Without legitimate tort reform, US health care reform is just a political slogan.

Million Med March

Physicians across the country met with elected officials this week in Washington, DC, in what is being called, "The Million Med March." The "March" was conceived as a vehicle to pressure Congress to retool the health care reform effort. The emphasis is on tort reform, which is one of the main failings of both the House and Senate bills. Here's the rationale behind the "March",  as described by a fellow OB-GYN, Dr. Richard Chudacoff.