The American Spectator

With Truman we had a “common-man” president dealing with an egomaniac general.

With Obama we have a “common-man” general dealing with an egomaniac president.

At least with Truman and MacArthur they were both on our side…..
—Jerry Howard

“Indeed, if a president and his team cannot handle the heat of public scrutiny and public involvement, then they are not fit to preside over the executive branch of the United States government.”

Indeed.
— C. Kenna Amos Jr.

PARTY ON
Re: Rossen Vassilev’s A Familiar “New Face” at UNESCO:

Reading about these ex-communist apparatchiks re-inventing themselves always reminds me of a joke that was current in Poland when the Iron Curtain came down. The joke went that if you joined the Communist Party the Party would reward you with one year’s free membership. If you also signed up another new member then the Party could waive your membership dues for ten years. Sign up two new members and you would get free life membership, sign up three new members and you would be allowed to resign from the Communist Party and if you signed up four new members you would get a certificate saying that you had never been a member of the Communist Party.
— Christopher H

FEELING THE MONEY CRUNCH
Re: Guardians of Democracy:

I admit I had been confused as to why any physician would be for a government takeover of healthcare. Until I spoke to a few doctors for my recent treatments. One doctor in particular was quite to the point..

1.) The physicians will be paid-for each medical encounter with a patient. Most doctors carry a load of “bad debt.” That is, a number of patient bills for which they will never be paid. Either insurance will not pay or the patient will not pay. This leaves any physician with a heavy overhead, nothing to pay his staff, his personal assistance, rent, continuing education or new equipment. The thinking is that taking a lower payment for services rendered will be more than balanced by receiving payment for every service delivered.

2.) In spite of public perception, many if not most doctors think Medicare is the most efficient insurance in the world. Why? Again, the physician will be paid. Maybe not promptly; but eventually. Most of all, however, physicians know what the rules are and how to follow them. They know exactly what will be paid for and how to code in order to by paid.

What most of the public frequently does not understand is that not all policies issued by a particular insurance company are the same. A policy Diversified Widget Company “X” has from “The Daily Oatmeal Insurance Company” for its employees is likely not the same as the policy United Porkbelly Company “Y” has from the same “The Daily Oatmeal Insurance Company” for its employees.

Each company which offers health insurance to its employees negotiates its desired mix of benefits according what it is willing to pay. For instance, Diversified Widget Company “X” may want to decrease mental health benefits for more coverage for dental care. United Porkbelly Company “Y” will want a boost in physical therapy coverage in a tradeoff with lower chiropractic benefits. Multiply this with thousands of different policies and physician needs a wholly separate staff just to handle insurance issues and billing. One payer with one set of benefits and one set of rules is white sands and fair winds compared to the congestion of a rush hour freeway.

Of course, this is likely to be shortsighted. Physicians may be rolling in the dough at first-until the government starts feeling the money squeeze. Then they’ll relearn what they already knew. The government does not negotiate with you. It negotiates only with itself. It will come up with a series of mysterious reimbursement calculations determining what should be paid for what service. It could be as simple as a “most favored nation” scheme in which the government takes the least cost charged in any part of the country for a particular service and apply that to the rest of the country as all that can be requested for reimbursement. Follow that procedure for the thousands of physician or medical facility-delivered services and those medical recourses will soon start losing money. With the next money squeeze, the American healthcare “system” will take it in the shorts. Young people will see the crunch physicians and medical assistants find themselves in and those same young people refuse medical schooling for other careers.

Whatever you may think of those %;!!&* doctors, but the fact is they take on more training, responsibility and risk for less than many in business and the charities who have less education, talent and skill receive. Until you hold another person’s life in your hands, you cannot appreciate this disparity in priorities. The odd reality in healthcare is that the money isn’t in direct patient care but often those furthest away from where the real action is.

If the government takes control, guess where the money will be.
— Mike Dooley