Coburn vs. the Earmarxists

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An update on Oklahoma Sen. Tom Coburn's efforts in Washington:

On Monday, Bob Novak reported that the Bush Administration is blocking release of the pork-barrel database that has been championed by Coburn:

As part of "Sunshine Week" to promote transparent government, the Office of Management and Budget (OMB) last Monday was supposed to release a comprehensive database revealing the number and cost of earmarks since 2005. It did not. The word on Capitol Hill was that the OMB was muzzled by the White House for fear of offending powerful congressional appropriators....

But just as the OMB was prepared to put out this information, it sent word to Capitol Hill that -- over its protests -- it was being kept under wraps by the White House to appease the appropriators. With Congress in the midst of the budget process, President Bush's team did not want to stir up the Hill.

All that was released last Monday was a compilation of earmarks in 2005, with few details. [OMB Director Rob] Portman publicly called it "an important first step towards providing greater transparency." In private, however, he said last week: "My hands are tied." Republican Sen. Tom Coburn, the scourge of earmarks, told me: "I think the American people should be very disappointed."

Coburn has also introduced health-care reform legislation aimed at bringing choice and free-market discipline to bear on health costs. Here, from a press release from Coburn's office, are the key features of the proposal:

  • Promoting prevention. The legislation will reform our rudderless and wasteful federal prevention programs and demand results and accountability. Five preventable chronic diseases – heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes – cause two-thirds of American deaths. Seventy five percent of total health expenditures are spent to treat these largely preventable chronic diseases. A sound prevention strategy will save countless lives and billions of dollars.
  • MediChoice tax rebates that will shift tax breaks away from businesses to individuals. Giving Americans a rebate check ($2,000 for individuals and $5,000 for families) to buy their own insurance will foster competition, improve quality and drive down prices. This provision will help put individuals back in charge of the health care, and help restore the doctor-patient relationship that has been severed by third-party government and health insurance bureaucrats.
  • Creation of a national market for health insurance. The bill would give Americans the right to shop for health insurance anywhere in America. Patients should not be forced to be pay for outrageously expensive health plans in states like New Jersey when they can save thousands by buying plans from companies in other states.
  • Creating transparency of health care costs and services. This Act requires hospitals and providers receiving reimbursements from Medicare to disclose their estimated and actual charges for all patients as well as the rates they are reimbursed through Medicare and Medicaid. This provision could allow patients to “Google” their doctor and comparison-shop for health care the way that they do for cars, computers, or other products and services.
  • Securing Medicare’s future by increasing choice and encouraging savings. The bill retains existing benefits but encourages true competition among private plans to hold down costs, a model already is working in Medicare’s prescription drug benefit. The plan would give Medicare recipients similar health care options available to Members of Congress and employees of Fortune 500 companies.
  • Keeping Medicaid on mission. The bill liberates the poor from substandard government care and offers states the option to provide their Medicaid beneficiaries the kind of health care coverage that wealthier Americans enjoy. The bill creates incentives for states to achieve private universal coverage for their population. The bill offers states the freedom to design the programs that serve their beneficiaries with the best care instead of the current, one-size-fits-all straitjacket.

Minimize red tape, increase consumer choice and transparency -- sounds like a good approach.

You can read more about the rationale for Coburn's medical reform bill here, where you'll find a link to a more detailed discussion of the proposal. An excerpt:

Have you ever wondered why is it that in America, patients can not choose their own doctor? Why, in the land of the free, do government bureaucrats, insurance companies and employers make your health care decisions instead of you? Why do health insurance costs increase faster than your income? Why are prescription drugs prices cheaper in every other country when the medical research is often funded with U.S tax dollars? And why does the U.S. spend over $2 trillion annually on health care, more than any other nation, and 45 million Americans do not have access to health insurance?

The answer is simple. Unlike every other aspect of American life, there is no free market in health care. Well intentioned, but shortsighted laws passed decades ago removed patients from their own health care decisions.

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S. Lee said:

When I see a new "List O' Things to Fix Health Care", there are usually some valid points. But when it comes to the usual line about "free market", I'll have to disagree and say there is nothing about current health care that prevents "free market" exercise of choice. The problem is that it's an irrelevant point. Health care doesn't work that way.

When my wife and son were in a car accident, they were taken to the emergency room at a local hospital. We had health insurance from my job. My son required a few stitches in one leg. That's it. Nothing more. The total cost to the insurance company (and those who pay the premiums) totaled about $20,000.

You might be inclined to think I'm leaving something out, something I glossed over. Not really. The majority of the cost was the MRI scans "to check for internal bleeding" even though the visible external damage did not suggest any significant probability of that.

I see two possible motivating factors for the MRI scans: Extreme legal paranoia; the chance to milk an insurance company (and those who pay the premiums) for a stack of dough. Although my opinion is not an authoritative one, I'll opine that it was a tiny bit of the former and a whole lot of the latter. Now, tell me how the "free market" and my "choice of doctors" could have addressed this.

In a way, market forces did eventually (sort of) come into play when company employees were told by the insurance company not to use that hospital. (They later patched things up.)

That example is a little extreme, so how about something more ordinary: Recently, the wife got a blood test for hormone levels to check for menopause. The price was about $600. I'm not the expert, but that does seem a little pricey to take a little blood and check for a hormone or two. So, what do I do? Do I take the costs and go walking into some doctors' offices, interrupt the doc, and ask him/her what he/she would charge? I think this would go over about as well as a turd in the Sunday punch bowl. Ain't gonna happen.

I'm doubtful the free market works with health care. However, what might work is a plan that successfully uses the big ol' greedy ol' insurance companies to control the big ol' greedy ol' medical and pharmaceutical entities without crushing the consumer in the middle of a match between 800 lb. gorillas. Sort of like controlling an insect pest with a natural enemy of the pest rather than insecticide. The consumer CAN shop for insurance; and the free market CAN apply there. I realize that 800 lb. gorilla versus 800 lb. gorilla is a lot easier said than done. But if somebody can figure it out, that's what I'll bet on.

The prevention stuff sounds good. And if cost coverage for the prevention can be universally provided (recall that $600 simple blood test?), and if people don't have to take a half day off from work so they can sit two hours in a waiting room before getting looked at, it might help. (Note to Tom Coburn: Americans are not known for their patience and love of sitting around waiting ... unless it's on a Jet Blue jet.)

From what I can read of Coburn's "plan" in the blog, I don't think it will ever amount to a hill of beans -- even if it gets passed. I think Tom has seen the medical trade from the provider side rather than the common consumer side and appears to be banking on "free market" having more mojo than it really has in this situation.

TheAngryPatient said:

Thank you S. Lee. Very well said and agree with you 100!

I would like to know how Patients with 100% medical insurance coverage (retired with medicare plus private insurer) can avoid becoming the guinea pig pin cushion to make up for the uninsured people? You know that's what happening.

We have heard horror stories about people who get admitted to hospital for what should be fairly minor issues and end up having a three week internment at the hospital. On the other hand - you hear horror stories about people with NO insurance getting sent home on their death beds - recall "patient dumping" article posted here not too long ago.

Is there any truth to the fact that Medicare allows for a minimum 3 week hospital stay depending upon the diagnosis - thus resulting in medical diagnoses that are far more serious than what patient originally went in for? We have heard that story more than once.

The "World of Medi-Sin" (c) is having it's own healthcare crisis.

'Kris' said:

You want to know about another medical scam? Well, it goes something like this.

It's called the " Multiple Mammogram Scammogram"

You see, the techs "accidentally" get a smudge/fingerprint on the x-ray cartridge. When it is developed, it shows up as an 'artifact and/or possible microcalcifications', they call it. So, that's enough to get you in for multiple mammos and enough for insurance to be required to pay.

Then they take several more painful mammos, all the while apologizing and saying "Oh this is really common. Most of the time it's just an anomaly on the cartridge".

In the end, it's nothing more than that anomaly from a "possible fingerprint or smudge from someone's finger" and how "we are so sorry, mistakes do happen but we would rather be safe than sorry. We try so hard to be sure this doesn't happen to people but we are only human....."

I call it Russian Roulette with women's lives because all those X-Rays are as good as contributing to cancer as anything else!

Makes me very mad that they play on women's emotions this way. Ask any woman if this has ever happened to them.

Also, how many women are scarred due to blood blister forming from excessive mammos and skin separating from the fatty tissue. They say "It should clear up in a few weeks." Yeah right. Months later and women are still trying to put makeup on an area that is exposed when they are wearing a bathing suit or any type of lower cut tanks or t's. It's a permanent bruise.

It's abusive.

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This page contains a single entry by Michael Bates published on March 21, 2007 5:21 PM.

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