From: Walter Miles <waltmiles at comcast.net>
To: WSFA members <WSFAlist at KeithLynch.net>
Date: Thu, 10 Oct 2013 23:59:14 -0500
Subject: [WSFA] Re: A point of information about the government shutdown
Reply-To: WSFA members <WSFAlist at KeithLynch.net>

>> As Mark pointed out, Sen. Baucus (and others, many also Democrats) made
>> that more difficult.
>
> On the other hand, it's overwhelmingly Republicans who have fought tooth
> and nail since Truman against any kind of national health care system.

Absolutely true.  But many Democrats have moved right (I mean wrong) in
recent decades.  Forty years later, we've passed something like Richard
Nixon's healthcare plan.

>> *End of life care*

> <snip>
>> just for poor people.  Talk of "death panels" sure didn't help.  It may
>
> Which, I will note, was 500% from the right-wing media. The idea of

They spread it, but Betsy McCaughey (Manhattan/Hudson Insts.) made it up.

> someone with training discussing with someone whether the extreme
> treatment is actually going to help you live better, or just suffer
> longer, seems to bother them.

Either it bothers them, or "death panels" is just too good a lie to pass
up.  I suspect this kind of counselling would *save* money for insurance
companies, but they wouldn't defend it because they hoped it would kill
the whole law, which ostensibly they'd been bribed into not opposing,
but, hey, who says you can't have it all!

> <snip>

>> *Malpractice vs. quality control*
>>
>> I *do* believe the reports that malpractice insurance cost rose early in
>> the 2000s because of diminished financial market returns rather than
>> increased jury awards.  But that *ain't* where it's at.  The worst thing
>
> You're missing the real issue: over and over, I've read that 10% of the
> doctors are 90% of the malpractice suits. And that the medical boards
> really, *really* don't want to pull licenses. We need government-run
> ones, since we see, over and over, that "self-regulation" doesn't work.
> And they need to be aggressive.

My point is that routine quality control will produce more savings and
more performance improvement than any form of heavy duty punishment.  The
hope is that the very bad guys will get caught screwing up little things,
and either get better, move to more suitable jobs, or at least create a
paper trail that makes it possible to take away their licenses (or put 'em
in jail if need be) sooner.  I agree that government at the national level
should provide the regulatory framework, but I think the *key* is to have
a broader group (doctors, PAs, nurses, hospital administrators, social
workers, pharmacists, citizens) watching medical professionals.  (Doctors
would *hate* it :-))  As you do point out, a review board composed of ONLY
your "peers" will be reluctant to take action.

> We *need* a single payer, public option. There's a bill that's been

As a devout Kucinichian, I prefer single payer, although I imagine a
public option would turn into that in time.  The P.O. scares insurance
companies, so they must agree, too.

> introduced in both the House and Senate to do that. But that's
> *improving* the ACA, not starting from scratch.

Yes.  As limited as it is, repealing it and having to argue it all over
again is madness.