The Right Prescription
Mom Gets Sick: Why Scott Brown Should Listen to Dr. James Rich
Health care hits home: Pennsylvania doctor’s health care paper ignored by Democrats Specter and Casey.
It began with a cough.
Which became pneumonia, a small stroke and atrial fibrillation.
The patient? My 90-year old Mom. Perfectly fine partying with family at Christmas, two weeks into the New Year she was suddenly in an emergency room with all kinds of tubes, wires and needles running in and out of her. Possessed of extraordinary good health — her last medical run-in almost 30 years earlier — abruptly she was in the middle of the most hotly debated political issue in America: the American health care system.
Which meant, of course, that as her only child I was now along for the ride as well.
This journey (she’s recovering in sturdy fashion — and yes, she had insurance) brought us into contact with exactly what’s right about American health care — and a doctor who has been trying and failing to get the attention of elected officials to discuss what’s wrong. That doctor is, in the aftermath of the Scott Brown rebellion in Massachusetts, the very embodiment of why so many Americans are so furious about the handling of the health care issue. According to the latest Gallup/USA Today poll, “An overwhelming 72% of those surveyed Wednesday say Brown’s victory ‘reflects frustrations shared by many Americans, and the president and members of Congress should pay attention to it.’”
Case in point: James F. Rich, MD, a partner in Connor, Rich Associates, a Heritage Medical Group practice in suburban Harrisburg. Dr. Rich, along with his colleagues Dr. Robert Kusztos (her longtime physician) and Dr. Claudette Jatto, have gone above and beyond the call for Mom. Not to mention Denise the Dallas Cowboy fan and blood tester extraordinaire. But there was something else here as well.
Sitting bedside for what seems like endless hours in a hospital is something many Americans experience somewhere along the line. In this case, I was lucky. As Dr. Rich made his daily calls on Mom, the television overhead reporting in increasingly astonished tones about the emergence of Scott Brown in his now famous race for the U.S. Senate against Democrat Martha Coakley, conversation turned to the obvious. What did Dr. Rich make of all this?
The answer astonished.
It seems that Dr. Rich, a thirty-year specialist in Internal Medicine who spends every day of his working life “caring for adults and dealing with acute and chronic disease,” was so disturbed about the turn the health care issue had taken that he had begun devoting considerable off-duty time to writing a white paper on the subject. “I’m not a writer,” he told me somewhat sheepishly, as he described his unsuccessful attempt to bring the results of his work to the attention of his elected United States Senators — Pennsylvania Democrats Arlen Specter and Bob Casey.
“Did you send it to them?” I asked?
Well, actually, Dr. Rich had done better than that. He personally took copies to their Harrisburg offices — and never heard a word from either Senator. He had gotten it to Republican Congressman Todd Platt, who did respond — but Platt, of course, sits in the House of Representatives run by Nancy Pelosi. So much for that.
I was incredulous. Dr. Rich may not be a famous TV doctor, but he is in fact a highly respected practitioner in this Pennsylvania community. And no response on the most important issue of the day from his two U.S. Senators, both of whom are staunch Obama supporters and of ObamaCare? None? Zip?
That is correct.
The treatment of Dr. Rich, in effect just blowing him off, is in fact emblematic of precisely the frustration profiled in that Gallup poll. It is exactly why Massachusetts voters responded so well to Scott Brown. Like Dr. Rich, Massachusetts residents were doing everything they could to tell their elected officials there was a better way to do health care. They felt no one was listening. Not the President. Not Nancy Pelosi and Harry Reid. And in Pennsylvania, in spite of those raucous televised town meetings where Specter parried with angry constituents, not Specter or Bob Casey, Jr.
What kind of people were the President, Reid and Pelosi really listening to?
About the Author
Jeffrey Lord is a former Reagan White House political director and author. He writes from Pennsylvania at jlpa1@aol.com.
Letter to the Editor View all comments (95) | Leave a comment
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moron| 1.26.10 @ 6:35AM
Malpractice attorneys would love Dr. Rich's system of medicine.
ds80| 1.26.10 @ 7:45AM
Because it works? What, in fact, is your point?
Appleby| 1.26.10 @ 6:41AM
The real point of the *Health Care Reform* brouhaha is POWER. The gaining and wielding and hoarding and horse-trading of POWER, over you and your Mama and everyone you know. Forever.
If only people would start realizing that these people have no interest in Health Care or intention of improving your life, and start realizing that all they want is the POWER of life and death over you and yours ... then we would get somewhere.
The question is, WHO is going to rule your life, up to and including HOW LONG YOU WILL LIVE. You and your doctors? Or people who cannot persuade a hippie to tak a bath?
BobU| 1.26.10 @ 7:07AM
Appleby above is exactly correct. Our very own, real-life "Manchurian Candidate", Obama, and his band of thugs, continue their apparently incompetent destruction of our Republic because their true goal is complete and permanent control of "The Herd", i.e., the vast majority of U.S. residents.
Shine| 1.26.10 @ 7:19AM
Yes POWER, which is the same as CONTROL, which facilitates the TRANSFER of WEALTH. That is the singular agenda of this administration and the Left Wing Fascists who now control D.C. The good Doctor is looking for an audience in Washinton. They used to smile at your face and pretend to listen. They already know what you are just beginning to understand. It's not about healthcare.
The Bishop| 1.26.10 @ 8:08AM
God bless Dr. Rich and his efforts. The arrogance of those in power is nauseating. And it's becoming chronic rather than acute. May Dr. Rich's tribe increase. And may Mrs. Lord fully recover.
Ken (Old Texican)| 1.26.10 @ 8:35AM
Mr. Lord
What a splendid column!
We work with the "Dr. Rich-es" all over the country.
Man, they work long hours...at high stress/peak type performance for many of those hours...and grinding paperwork for many of those hours.
As Senator Brown stated very clearly: "We can do better!"
Doing better in my mind...begins with polling and questioning the great docs on every corner.
Again, thank you for this snapshot.
Lazy Jack | 1.26.10 @ 8:37AM
Dr. Rich may be an abnormality among healthcare providers, unfortunately. Why? Healthcare is the most heavily government subsidized enterprise in the United States. Nearly 50% of all healthcare is already paid for by a government entity. What incentive to hospital administrators, nurses, public health officials, etc. have to apply some critical thinking to the system? More money from the government means, frankly, less oversight. Unless, of course, you are the Mayo Clinic. Those guys could see the writing on the wall.
Dr. Rich's story actually gets at the heart of the problem. A government, by definition, has no conscience. Is that what you want making decisions for your mom?
Lazy Jack
http://thanksforthelaughs.word.....onscience/
http://thanksforthelaughs.word.....irca-2009/
Sheila| 1.26.10 @ 8:51AM
Great ideas in this article. I firmly believe that MY health is MY responsibility and YOUR health is YOUR responsibility. Unfortunately, democrats do not see it this way.
Denver Todd| 1.26.10 @ 9:25AM
Mass already has socialized medicine. This doesn't seem to be mentioned as an element of the state voting against Obamacare via Scott Brown.
DG in GA| 1.26.10 @ 1:08PM
Denver, the people of Mass. who LIKE their socialized medicine, voted for Brown because they didn't want to have to pay even MORE under the Obamacare proposal. A lot of the people in Taxachusetts realized that their state-run system would be replaced by Obamacare, so they would pay more and get less. They were also angry about the concessions that were made in order to buy the votes of representatives from other states, while believing they had Taxachusetts in the bag.
Bob| 1.26.10 @ 9:51AM
Jeffrey -- you fail to mention your mom's insurance is a government run health care plan -- Medicare. How can you think this is good for your mother yet not good for others? That makes no logical sense. In fact, you didn't even mention this once because you know I'm right.
Regarding nursing homes, they average a cost of $8,000-$12,000 per month. Now how many people can afford that? You conveniently leave out the details -- and that's where the devil resides.
So what would your mother do without Medicare? You do realize in a private system her annual insurance premiums would be in the range of $25,000 per year. Can she afford that? Remember that insurance companies are private enterprises that must make money. We want people to pay for their own liability, so if you really want that then prepare your mom for the high premiums.
Regarding a response from Senators/Presidents, how many letters with advice do they get? Perhaps 10-20,000 per month? Do you really expect them to check the credentials of everyone who writes a letter and then respond to them?
That said, we do need chronic care alternatives that are more cost effective. But there is no reason for insurance companies to encourage that as they are not responsible for that expense. Therefore, you are actually calling for MORE government, not less. And yes, we do need tort reform and competition through national insurance companies.
So, Jeffrey, next time let's be honest and tell the whole story. Regarding that mythical creature in the sky that reduces your hospital stay, did you ever actually read the details of those studies? If you did, you'd see that it is not clear that it was "prayer" the provided the benefit. There are lots of factors that are more important including the socialization benefits of belonging to a group.
Let's deal with the whole truth next time. I believe that health care is a privilege, not a right. If your mom could not afford the private insurance of $25,000 per year, she could sell her home for that care. Right????
Todd Lupold, PA-C| 1.26.10 @ 12:21PM
Bob,
Stop defending a failed system and a failed proposed "solution". The Dems are simply making a power grab not trying to provide anyone with healthcare. We are trying to provide better healthcare and are being hindered not only by insurance companies but by the government as well. Neither entity has the answers, we believe we do have some of the answer if we can just begin implementing them to save money.
DG in GA| 1.26.10 @ 1:13PM
Guess what, BOB: my Senators and Congressman actually do reply when I write to them. and I get a VERY personal, specific reply when I send them an article or other writings on a salient point. So even if the response comes from a staffer, it shows that SOMEONE in my representatives' offices is reading what I write. I think it is the height of arrogance that the doctor received NO response from HIS Senators.
Do you want to know what happened when MY doctor wrote to HIS representative? He was asked to serve on a task force made up of medical professionals and Congressmen to hammer out alternative proposals to Obamacare. Now who do you think is going to get re-elected?????
Interested Conservative| 1.26.10 @ 11:32AM
Bob - That's an awful lot of dry straw men you've packed into your comment. Stay away from matches.
Just to pick one, Mr. Lord's mom is covered by "insurance" - right there in the fifth paragraph. Is is Medicare/Supplement/private? Does it matter for this article? Perhaps a little bit, but did you even read it, or are you taking the Specter/Casey approach?
Is Medicare part of the problem, the solution, or both? Is the problem health care, health insurance, health, or parts of all three?
What does the POTUS propose, the democrats in congress, the GOP?
Maybe there's just too much nuance involved and we should simplify matters with a single-payer, single-provider, single-source system?
Margie| 1.26.10 @ 1:42PM
"Bob - That's an awful lot of dry straw men you've packed into your comment. Stay away from matches."
~Good one. I think Bob should rename himself "Bob the Straw Man." Quite fitting, ~hay Bob? :^)
Tony in Central PA| 1.26.10 @ 11:33AM
The elephant in the room is Tort Reform. Pennsylvania has a terrible problem keeping and attracting young doctors due to the exhorbitant cost of maplractice insurance. Billions of dollars are also wasted every year on useless tests in the practice of " defensive " medicine.
I agree it makes no sense to have people who know almost nothing ( politicians, bureacrats ) about something ( our health delivery system ) decide how it should work. Obama didn't stick to his own promises of how he would pursue health care legislation and it finally rose up and bit him in the backside.
Marc Jeric| 1.26.10 @ 2:08PM
Right! Tort reform is the answer. We have 1,100,000 lawyers in this country; Great Britain, Germany, and Japan only some 35,000. How come? Well, here when you sue somebody and lose, you just walk away and look for the next victim; elsewhere, you lose and are automatically assessed the costs, direct and indirect, of both the court and of the defendant. Our trial lawyer hyenas have sucked us dry - did you see their commercials on TV, trolling for "victims" of medical malpractice?
Jeffrey Lord| 1.26.10 @ 11:34AM
Bob...
The point here is the tremendous amount of waste...which of course jacks up the cost. I don't believe health care is a right either.
And....yes, in the day and age of the computer, having worked for a senator and a president, I can say with assurance it's not at all difficult to keep tabs on the credentials of interested constituents. It's done every day.
Bob| 1.26.10 @ 12:13PM
Jeffrey, I see you didn't address the issue of your mom benefiting from a government run health care plan. She could probably not afford a private plan -- right??? If health care is truly a privilege, then your mom should not have Medicare. It is welfare, right??? You know the benefits she gets are far more than she paid in...
And yes, I am familiar with computer technology. I build my own computers and used to write software. I can tell you that keeping track of 12 million people (the population of PA) is NOT easy to do -- even with computers. How do you define them as "interested"? Did they give to their senatorial campaigns? What software do they use and how do they do all of that data input? I doubt that your computer assumptions are remotely correct especially at the Senatorial level.
If you truly believe that health care is a privilege, then take your mom off of Medicare and pay for the hospital stay out of your salary. What angers me is the hypocrisy in your point of view. I'm all right with people dying if they can't afford extensive care. If you truly believe that health care is not a right, you should be fine with that as well.
Thom| 1.26.10 @ 12:27PM
Reducing chronic care time in Hospitals will reduce overall medical cost but it will bankrupt most Hospitals unless other measures are done to reduce the fixed cost of Hospitals. Hospitals and Hotels have a lot in common where as staying in business is concerned.
The Medical System I worked in was profitable but all three Hospitals were money losers and subsidized by the medical practices outside of the Hospitals. 80% of their business was Medicare/Medicaid. A few percentage points less occupancy rates for any length of time results in bankruptcy. A lone Hospital that catered to the “Poor” tried for years to survive on just Medicare/Medicaid payments and went bankrupt. Perhaps looking at what drives up Hospital cost before we reduce their occupancy rates would be in order.
Regarding $8,000 -12,000 a year nursing home cost well that probably depends on where you live and the richness of one’s wallet more than anything else. My mother’s cost $3,000 a month and $740.00 of that was her mandatory required SS payment. If we are going to complain about the cost of Nursing homes we might not want to be caught in any Hotel Chain within 50 to 100 miles of most large urban areas. The last “economy” Hotel chain I stayed in near Washington DC charged exactly the Government approved $224.00 a night charge. That’s $6720.00 a month the government will gladly reimburse and all you get is a room, bed, free TV, a shower, a toilet and a light breakfast. The same Hotel in Atlanta cost $124.00 a night; in the middle of North Carolina about $80.00 a night. The gated community types need to get out more and see what things really cost for most people in the rest of the country. I don’t sense a Hotel cost crisis among those that have had their company's pay for all those nights Hotels that make their mortgage payments look like pocket change.
Bob| 1.26.10 @ 12:36PM
According to industry statistics, average nursing home costs right now are about $168 per day or over $61,000 per year. It is true, if you are toothless and live in Kentucky, it will cost less but if you are in PA like Jeffrey's mom, it will cost more. That average number, though, is a bit misleading. Most nursing homes will only take you if you can afford your first year's expense. If you last longer, then you are covered by Medicare/Medicaid which radically lowers your cost. I know this is true since my wife used to run a nursing home.
That said, you are absolutely correct that hospitals will lose because they have an unfunded mandate requiring them to treat everyone. We need to fund that mandate if we want hospitals to survive. In my area, one third of the hospitals have gone bankrupt and closed.
Perhaps you country types need to get out more and go see some of them big cities. That's where most of the people live.
Tony in Central PA| 1.26.10 @ 12:55PM
I wonder how many people realize the kind of losses community hospitals have to absorb to keep functioning ? It doesn't get discussed much in this forum, but I can tell you that community hospitals usually end up subsidizing their competition for patients who are able to pay. It works like this : many specialists start out at their community hospital, but after they build their practices, they invest in their own facilities that pull paying patients away from the hospital. The speciality practices are often built close to the hospital, especially in the case of surgical centers, that way, the hospital is nearby to bail the MD out if there happens to be a problem or bad outcome. Noncompete agreements are supposed to discourage this, but it doesn't often happen. In rural areas or places where there exists an undersupply of good specialists, hospitals have little bargaining power.
Thom| 1.26.10 @ 1:01PM
Bob, one of your problems is that you can’t take a dump without consulting a government report. It cost $3,000 a month, minus $740.00 of her SS payment for my Mom. Period. I was her executor, I had to set it up. Your other problem is you can’t carry on any conservation without insulting some “group” just for fun it seems. She lived in Kentucky btw so how about apologizing to all the people that live there you just insulted? Things cost less there than where you live I’m sure. I’m sure you can find a government report that says what the average cost of staying in a Hotel is too but I’ve got a $100.00 on the table that that average is way over any place I’ve ever paid for which brings us to the core problem doesn’t it? When it is your money on the line vs. free government money the cost of things get a little skewed don’t they Bob? Let’s see Bob, by age 67 my inflation adjusted contributions to Social Security will be just short of $600,000. That would be worth 2.8 million at market rates. I’d have to live longer than George Burns to get back the inflation adjusted amount alone. See a problem there Bob? Let’s try pre-medical insurance now. I’m currently setting at better than 15 to 1 ratio between what I’ve cost my insurance providers over my adult life vs. what has been paid into my plans in total. That difference is worth millions properly invested between the early 1970s and today. You think a 90 year old woman over her working life having invested what was taken for Social Security, Medicare/Medicaid and pre-paid medical insurance could afford a Nursing home? You bet and this is why all these government subsidy transfer payment programs don’t, won’t can’t work over the long haul. So you keep defending that which is bankrupting the Nation by destroying what should be invested over a person’s life vs. just taking it out of one person’s pocket as soon as he earns it and giving it to someone that has every incentive to not invest a dime in their future. Keep up the good work Bob.
Thom| 1.26.10 @ 1:38PM
I live in a City Bob, one of several in what was the 38th largest SMA at one time. My mother lived here but fled to KY because is cost too much to retire here on SS. Even here where real estate cost perhaps a quarter of what it does around Washington DC is unaffordable for most retirees and a full third of people on SS have nothing but SS which averages about $13,000 a year today. Can you make it on that Bob? For the next third of SS recipients SS is half their income so can you make it on $26,000 a year where “most people” live Bob? So yes Bob, most people live in the “cities” but only a fraction of the people who retire can actually afford to live there and a very large portion of this nation's poverty is located within sight of where the most expensive real estate and riches people live and bid up the cost of everything, including the cost of government run programs.
Todd Lupold, PA-C| 1.27.10 @ 7:54PM
Thom,
Your assumption is misleading. Reducing the treatment of chronic illnesses in the hospital will not necessarily bankrupt the hospitals. Keep in mind that what we are trying to reduce is the repeated re-admission of chronic illnesses such as COPD and CHF which can be treated at home and do not need a hospital. When these folks are admitted and re-admitted to the hospitals, the reimbursement is zero if the re-admission falls within the 30 days cut-off, therefore, hospitals lose money by caring for these patients. Our plan would keep these chronic readmits out of the hospital thus saving money. This also reduces the chronically ill patient's exposure to disease. Keep in mind that hospitals are for sick people and if you send someone who just has a small exacerbation in their chronic medical condition to the hospital they will not fare well.
Jeffrey Lord| 1.26.10 @ 12:36PM
Bob...
Medicare is not working. We are all trapped in a government run system that, as seen most recently with the Mayo Clinic stopping it, is not acceptable. Medicine, as Dr. Rich points out, is a commodity, not a right. Medicare is in debt to the tune of $36 trillion. She also gets, as does David Rockefeller, Social Security. That isn't working either. The way to begin to fix health care is eliminate the waste, make the private insurers affordable, and innovate. I believe we have to stop this. But removing my mother from Aetna isn't going to do anything. Getting Congress to stop trapping us all in this nonsense is the first call. You can't be all that angry - you voted for Obama, whose answer is to nationalize health care completely. I want out...you wanted in. Big difference. Besides, I thought you were a data guy. That is what Dr. Rich is all about...data, data, data.
And I can tell you from experience that a US Senator's office can retrieve your name, your correspondence and your interests in a heartbeat. One can quickly decide to set up a committee of doctors, plumbers or anything else that plugs in your constituent's interests to whatever activities the senator what's to plug them into.
Bob| 1.26.10 @ 12:50PM
We happen to agree that Medicare is not working. Basically, it is because people are taking out of the system much more than they put in.
You may have worked in a Senator's office, but I was a group insurance executive. If you give private insurers to run their business without significant regulation, then your mom would not be able to afford her hospital stay. Older people would be charged a lot more than younger people. I don't see how you can support free enterprise and make private insurers more affordable at the same time. Please let me know how that is done -- and don't use tort reform and competition as your justification. I've seen the numbers and that doesn't buy you much.
And for the record, I'd rather go to government run health care than the mess we have right now. At least we would get some form of rationing. If you don't want your health care rationed, you could always buy a supplemental policy as many on Medicare have done. We know the only way to reduce medical costs SIGNIFICANTLY in this country is some form of rationing so we don't spend so much on emergency care and care for us older folks.
By the way, using the Mayo Clinic as an example is a red herring. They have a specialized clientele and are not like most clinics and hospitals who must take trauma and indigent patients are high levels. They are also not located in an area that has high illegal alien populations.
And by the way, your understanding of computer systems seems limiting. Retrieval is easy. Data input requires labor and time. That means for each letter sent, some human needs to input information into the system. That is the limiting factor.
Regarding voting for Obama, I would, and will do it again if Palin or another populist idiot runs. If the Republicans run an educated and intellectually curious person like a Romney, I will vote for the Republican every time. I cannot support a party that runs uneducated and incurious nerfs like Palin.
Jeffrey Lord| 1.26.10 @ 1:00PM
"They are also not located in an area that has high illegal alien populations. "
The news story said the branch of the Mayo Clinic they were citing was located in Arizona...and they do indeed have a serious illegal immigration problem.
"If the Republicans run an educated and intellectually curious..."
Robert McNamara for President! Bob, respectfully, this is just intellectual snobbery...empty calories from start to finish...and it has nothing to do with Palin.
This is said routinely about every GOP president from Ike to Ford to Reagan and the Bushes. And it is always the intellectually pretentious that get us into trouble..from Vietnam to nationalized health care to interrrogating the Xmas bomber for a whole 50 minutes before Mirandizing the guy. Give me solid common sense any day of the week.
Jeffrey Lord| 1.26.10 @ 1:12PM
Bob...
Out of curiosity...if Obama is so smart, why is he in so much trouble?
Thom| 1.26.10 @ 2:03PM
He is in trouble because the majority has figured out what the true cost of snobbery is going to be and at the end of the day they are going to pay more for everything while getting less of everything for that. Those dependent on the King will benefit in the short run but the rubs outside the golden palaces of Obamaland have seen what their future is under the most high and intelligent King from that mystical place known as “Harvard”. What stands behind the façade of intelligence is revealed what it typically is. Just another con artist with a singular gift that isn’t paying the freight on this Con. Bob won’t respond to your question Jeffery because he can’t find a government report to back up the King’s intelligence. Such things are a matter of “faith” between Harvard people I hear…..
Bob| 1.26.10 @ 3:00PM
Thom, I answered the question and it was not a government report, but a private poll. By the way, my wife was born in Kentucky and I may retire there. I kid her all of the time. I'm losing my teeth, so Kentucky is a perfect place to retire. By the way, I though political correctness was the purview of the left!!!!!
Thom| 1.26.10 @ 3:37PM
Bob said, "if you are toothless and live in Kentucky,". I can recommend a Nursing Home for both of you Bob. They will even take coon skinned hats as payment....
GregA| 1.26.10 @ 2:01PM
Recently, the large academic medical center where I have been employed for 20 years, instituted a policy that prohibited any vendor supplied food, pens, shirts, hats, briefcases, happy hours and golf games. Very rightly, by accepting these modest tokens, we could give someone the impression that treatment decisions might be influenced by the manufacturers and suppliers. When I explained this policy to the vendors that I do business with, I told them to make sure that whatever was saved by this proscription, be passed along to our elected (or appointed) government officials as they surely would not object to receiving these emoluments.
Bob| 1.26.10 @ 2:56PM
Jeffrey, you said this:
"Out of curiosity...if Obama is so smart, why is he in so much trouble?"
If Reagan was so good, why, after his first year, was his presidency considered a failure? Reagan's approval ratings in 1982 and 1983 were much lower than Obama's. Why? When the economy improved, Reagan's approval ratings went up. Here's a reference since so little is done in AmSpec to actually look at the numbers:
http://en.wikipedia.org/wiki/F.....Reagan.png
You'll notice is low of 35% was found a full two years after he was elected President and then rose when the economy improved. I'm someone who actually looks at the DATA from history. Obama is now at about 50%. So, Jeffrey, all you have to do is look at history to see that approval ratings and "success" are directly related to people's pocketbooks. Don't open that bottle of champagne too quickly (unless it is a cheap one, of course).
Let's get this straight, I'm not happy with Obama right now, but do you really think that the economy would be better under McCain/Palin? Economists are now stating that businesses are profitable, strong, and growing. Job declines are nearing an end and we will start seeing job growth this quarter. Employment is a lagging indicator and for this deep a recession, it takes from 18 months to two years for businesses to start hiring again.
But then again, Jeffrey, I know your an educated man who knows I'm right about this.
Unfortunately, almost all Presidents have on the job training. Both parties have far lower approval ratings than the President. When the economy improves, he will get a 10 point bump in approval ratings and you'll have to eat your words.
Obama is learning how to lead and has made many executive mistakes during his first year. Fortunately, he is bright and has the ability to learn (unlike McCain and Palin). This year he is going to attack jobs and federal spending -- and if conservatives don't back him on spending cuts, they have no morals.
iknownothing| 1.27.10 @ 7:18AM
If McCain and Palin were elected, and if they held spending to the same rate of increase as the previous administration (and not passed the Porkulous bill), I have no doubt the economy would have been better under them. But I realize those are pretty big "ifs".
Jeffrey Lord| 1.26.10 @ 3:10PM
Bob...
Since I was there I don't need to look up the Reagan record. The point, Bob, is that what Obama is doing does not work, in fact has never worked and will not work. Can things marginally improve? Sure. But Reagan had it right, Obama has it wrong. Reagan was right not because he was Reagan but because the principles were correct. Obama is wrong not because he's Obama but because the principles are wrong. Massive government spending will not salvage the economy, let alone build it. It doesn't matter who does it. And a smart guy like Obama doesn't know this? Well, no. This is why a promise that the stimulus would keep unemployment at 8% or below was nutty, and lots of people said so at the time. They (we)were right. It's now at 10%. So he will keep banging his head against the wall and wondering why he has a headache. This just isn't rocket science. But then, we have discussed before and just disagree....
Truth to Power| 1.26.10 @ 3:13PM
What a concern troll, not even a good one.
Bob| 1.26.10 @ 3:55PM
Jeffrey...
Of course you don't want to look up Reagan's record in terms of government growth, approval ratings, the increase in the debt, etc. The numbers just don't back up your rhetoric. I'm a business guy. I look at the numbers and judge by the results. Reagan's own economists don't think he did a great job. Let me quote:
"Reagan failed to achieve some of the initial goals of his initial program. The federal budget was substantially reallocated—from discretionary domestic spending to defense, entitlements, and interest payments—but the federal budget share of national output declined only slightly. Both the administration and Congress were responsible for this outcome. Reagan supported the large increase in defense spending and was unwilling to reform the basic entitlement programs, and Congress was unwilling to make further cuts in the discretionary domestic programs. Similarly, neither the administration nor Congress was willing to sustain the momentum for deregulation or to reform the regulation of health, safety, and the environment.
Reagan left three major adverse legacies at the end of his second term. First, the privately held federal debt increased from 22.3 percent of GDP to 38.1 percent and, despite the record peacetime expansion, the federal deficit in Reagan's last budget was still 2.9 percent of GDP. Second, the failure to address the savings and loan problem early led to an additional debt of about $125 billion. Third, the administration added more trade barriers than any administration since Hoover. The share of U.S. imports subject to some form of trade restraint increased from 12 percent in 1980 to 23 percent in 1988."
People seem to forget that one-third of the stimulus was tax cuts. ALL of the analysis of the great depression said that government spending was key to getting us out. In fact, even conservative economists said that government spending was not enough. In the end, it was government spending, albeit military, that made the economy go.
So, again, Jeffrey, let's get the rhetoric aside and deal with data and facts which you seem to avoid and/or discount. The 8% promise was politics, and you know it. His economists even thought it was going to be over 10%. Do you really believe it was going to be better under anyone? GDP started going negative in the first quarter of 2008. Was that Obama's fault? That's right, a Republican was President at the time. The GDP turned positive in the 3rd quarter of 2009. Hmmm... If Obama got it wrong, then why the turnaround? Businesses are tremendously profitable right now. If Obama was so anti-business, why did this occur? Hmmmm....
You are right, this isn't rocket science. You should actually look at the numbers in terms of approval ratings, GDP, etc., before you make ideological remarks which have no basis in fact and data.
Please. Show me you've looked at the detailed economic data and prove your case with inflation adjusted data. I've been waiting for someone here to do that, and no one can back your rhetoric with actual comparative graphical data. I'm waiting.....
Interested Conservative| 1.26.10 @ 4:04PM
Bob - Is there anything government, if expertly managed, cannot do?
Just wondering.
Bob| 1.26.10 @ 5:25PM
IC, my point is not that government should be larger, it shouldn't. It is that the old tax cut rhetoric is not consistent with the data. The focus should be on cutting spending -- and if you cannot cut the spending, then you should raise taxes. However, raising taxes should be a last resort. Government is NOT efficient. But the mush we have now as a "health care system" is even less efficient. Either we go to a market based system, or you give up and go to a government program. I'd prefer a market based system but that means that Jeffrey's mom would not get the care she received at the hospital. That is the trade off. In a free market economy, we should be willing to make that trade off. Right now, we have the extreme inefficiency of a system muddled between Medicare and private insurance regulated heavily by each state and allowed to have monopolies. That is the worst of all alternatives.
I would certainly cut many federal government departments. I would also cut military spending on some of the new technology. We spend more on military than all other countries combined. We need to be competitive, not overspent. I would also put some rationing in Medicare and Medicaid and cut that expense by 30% or so. If people want full coverage, they can buy a supplemental plan.
Thom| 1.26.10 @ 5:41PM
Bob said, “I'd prefer a market based system but that means that Jeffrey's mom would not get the care she received at the hospital. “ That’s speculation on your part Bob. Show me the “data” to back that up? I’ve got over $175,000 in 2010 constant dollars paid into health insurance. What would be the market value of that money today if invested in the Market over the last 37 years? My 2010 constant dollar health care cost is between 12,000 and 15,000 dollars which includes 4 trips into surgery. Your problem is that you don’t want to admit that most people are trapped into paying 15.3% of their income to “government “ run welfare programs now plus a similar amount into government regulated “health care insurance” welfare programs and can’t pay for both someone else to get free or subsidized health care and retirement and put away enough to get off the system for themselves. These transfer payment systems have always been a “trap” and you voted for the creator of these monsters.
Bob| 1.26.10 @ 5:47PM
Thom, please go to someone who knows how to do an inflation adjusted cash flow analysis before you make dumb remarks. The fallacy of your statement is that it assumes you've not used one penny of your health care dollars since you started putting money towards it. That's why much of it would not be available to invest in the market. It is a rookie mistake. If that's how you do your analysis, no wonder you've come to the wrong conclusion.
As I've said on numerous occasions, I'd prefer market based private system where all the government pays for is what it mandates -- emergency care. That would mean you could buy the coverage you want. If you opted for minimal coverage, you'd have to pay much more out of your own pocket. But it would also mean that Jeffrey's mom would not get the care she received. That is just a fact.
Thom| 1.26.10 @ 6:13PM
Bob, what is it you can't read what people write? or just refuse to listen to anyone else? I’ve got my tax returns back to 1968. Do you? I’ve got my pay sub deductions back that far too. I know what I’ve paid (employee + employer) portion toward health care insurance over those years. I know the inflation rate over those years. I can put that on a chart against my health care insurance cost and I can deduct what has been spent over my life time pretty well too. It gets easier because the bulk of my health care expenses was spent in the late 1990s thus any skewing from general inflation vs. health care inflation can easily be discounted out when you multiply the adjusted cost vs the adjusted payments over 37 years I’ve tracked. Guess what Bob, the difference is a damn big number just as the compound growth of my investments over that same time are pretty large over and above “inflation”. I suspect that is just as true for you so why do you think I can’t do compound math in an excel spreadsheet with all the factors factored in?
Interested Conservative| 1.26.10 @ 4:05PM
An alternative question would be whether, based on the data of course, you believe that Jimmy Carter's second term would have been any different than Reagan's first term?
Bob| 1.26.10 @ 5:27PM
IC, what the data shows is that government does not effect the economy very much. Economies go through business cycles notwithstanding who is President. The economy would have turned around under Carter. However, I doubt whether we would have broken the Soviet Union under Carter. That's why I think Reagan was the better President notwithstanding the debt he created.
Interested Conservative| 1.26.10 @ 4:09PM
Finally, a question about a source:
Where did this item come from: "Third, the administration added more trade barriers than any administration since Hoover. The share of U.S. imports subject to some form of trade restraint increased from 12 percent in 1980 to 23 percent in 1988."
That seems a very narrow nit to pick, considering, just to pick a random slice of data, the wage and price controls Nixon imposed in his second term.
Maybe "trade barriers" has a very specific definition in your source, but directly dictating the price of an item seems to be the ultimate trade barrier - and that was from a republican president.
Bob| 1.26.10 @ 5:28PM
I've posted this link before:
http://www.econlib.org/library.....omics.html
Interested Conservative| 1.26.10 @ 6:26PM
Bob - That's from Bill Niskanen, Cato and the Liberty Fund. That seems a weird source to be using to argue for anything resembling what the POTUS and congress are presently coughing up.
As for the gist of the argument. the democrats clearly prefer more government (either directly in the market, or increased FEDERAL regulation), while the point of Mr. Lord's commentary, and for that matter Dr. Rich's, is, at most, greater state regulation.
If anything, Cato would prefer neither, but I suspect they'd much prefer interstate compacts via NAIC, rather than Obamacare. To the extent federal legislation is required to do that, so be it.
Finally, what's so wrong about the GOP's general approach of incremental acts rather than the POTUS stated goal of being the last president to move on health care reform?
Is it too much to ask for prudence and modesty?
Thom| 1.26.10 @ 5:30PM
Bob said “In fact, even conservative economists said that government spending was not enough. In the end, it was government spending, albeit military, that made the economy go.”
This is false. Another government report? If this had been true we would have had significant bumps after Korea, Vietnam and even Gulf War 1. Didn’t happen. I believe there were recessions after each event and/or runaway inflation. Why did we grow after WWII, because it is the outcome of all that military spending from 1942-45 and over 300,000 dead that paved the way, literally to new markets and demands for goods and services from all the countries around the world that lay in ruin that provided us with the source of revenue to support all the industrial expansion we had done during the war. The outcome of WWII is the exception to the rule where as government spending simulates the economy. The Russians, Brits would certainly disagree that all that government spending brought about economic bliss. By that standard the Soviet Union and China would have been Utopia by comparison. At the root of economic expansion and business as usual is a psychological component that cannot be dismissed via a government chart. Reagan was a likeable guy with a tough job and he expressed his faith and belief in this country’s greatness in the scheme of things. He did not embrace government as the solution as his predecessor had and failed. Obama has a tough job and none of what I said about Reagan. That radiates from the top throughout the land. People aren’t going to spend or invest in significant amounts with that kind of negative, anti-business rhetoric and government knows best setting at the top of the government. Doesn’t work for the guy in Venezuela any better than it is going to work for his twin in Washington DC. It is more than just the words coming out of Obama’s mouth that turned off voters in Virginia, New Jersey and Massachusetts to his policies. Anyone that truly thinks government spending during WWII is what got us out of the Depression should be rooting for a repeat at least. The two brush wars to the tune of 1 trillion a year in military spending certainly isn’t getting the job done, is it? WWII spending was about 57% of GDP for that time. I just don't think Iraq and Afghanistan are going to need that many consumer goods from us. They can get them cheaper from China direct.
Bob| 1.26.10 @ 5:36PM
Again, Thom, do you know how to find and analyze data? We didn't substantially increase defense spending during the wars you named:
http://www.heritage.org/resear.....error.aspx
Therefore, your argument bears absolutely relevance to my statement. Yes, by ruining Germany, Japan, Italy, France and the UK during WWII, it gave us a competitive advantage. However, our economy started improving BEFORE the war was over, which proves my point. The longer term SUSTAINED recovery during the 50's was certainly affected by our competitive advantage.
Now please, learn how to do analysis.
Thom| 1.26.10 @ 6:03PM
Bob, your arrogant condescending mouth notwithstanding, we had a bit more than a competitive advantage after WWII. We were the only industrial power left standing and with that we dominated numerous capital industries around the world not the least of which were automotive, shipbuilding, energy production, agriculture and a brand new aviation industry. Where are those industries today? They aren’t very competitive from where I sit. We fed a large segment of the world for quite some time after the war. We were keeping Britain from starving for most of that war as well as aid to other countries so this statement “our economy started improving BEFORE the war was over” would have been true regardless of the outcome in the short term. As I said Bob, WWII was 57% of GDP between 42-45. If that is your idea of a solution I’m afraid you are going to be disappointed this time. There had to be a place for all our government spending (minus war materials) to go else we would have suffered just is typical after large run ups in debt (typically wars) and draw downs in spending. There was a place called “the world” and there is no comparable outlet for all this spending now, or since WWII. We have plenty of data points on this kind of scenario Bob since WWII. It does not work.
Bob| 1.26.10 @ 6:10PM
Actually, I have arrogant, condescending fingers.....
Please show me any graph of inflation adjusted GDP that proves your point. But you've proved my point, in any event. There are no other data points for either spending or tax cuts that show either stimulates the economy to any great extent.
Thom| 1.26.10 @ 6:22PM
When did I say anything about tax cuts? I responded to your claim (false) that government spending (military) boosted us out of the Depression (to Jeffery Lord per Bob). It did not but the outcome of that spending did period. You made the claim speaking for unnamed "conservative economists”. The only people who take that claim seriously follow the Keynes model and I lived through that in the 1970s and it does not work.
Bob| 1.27.10 @ 7:50AM
Thom, you don't know what you're talking about. Here's the data:
http://en.wikipedia.org/wiki/F.....ession.svg
You'll notice that the rise in GDP started prior to the U.S. involvement in WWII. I can't find any economist who argues that government spending did not help the recovery. Of course, some economists believe that we spent too much and some that we didn't spend enough. Perhaps you can actually show me the data that supports your hypothesis???? I doubt it....
Ken (Old Texican)| 1.26.10 @ 5:05PM
Mr. Lord.....speaking of banging one's head against the wall...heh...trust me.....engaging in a serious conversation with "Bob" is certainly in that category.
His art is mixing facts, suppositions, conclusions, and outright lies into a matrix.
Please just ignore him, for all our sakes. He is like the psychopathic killers we see on TV killing for notoriety.....heh.....except Bob just kills conversations with glee, like any crushing bore.
Bob| 1.26.10 @ 5:30PM
Better than talking to a pseudo-CEO who doesn't understand the bottom line and ignores data and facts. Please, Tex, show me the macroeconomic inflation adjusted data that disproves my comparative analyses. I know you don't have the education or training to do that, but please try.
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Ken (Old Texican)| 1.26.10 @ 6:46PM
OH, hi, Bob.
Have you managed to find me all over the internet yet, ignoramus...or must I give you a link?
The day I give you a link...I must come to kiss you.
Ken (Old Texican)| 1.26.10 @ 8:19PM
Hey there guys.
Thank all of you who DID look me up on the net...and emailed me.
I look forward to our ongoing private conversations.
Bob is STILL being retarded...heh he still has not looked me up.
darcy| 1.26.10 @ 11:02PM
Please STOP feeding the committed leftist named Bob.
He's here only for the thrill of the attention he gets.
Mr. Lord, you are patient in the extreme; but please let go of Bob: You're talking to a brick wall!
Curtis Rasmussen| 1.27.10 @ 12:32AM
The Lernaean Hydra Bob/ Liberal Reader/S.L.ick Toadturd is out in force. The rancid, poisonous prose spewed by the many headed beast belies the desperation of witnessing Scott Brown's victory.
To the many posters above and in other threads today, good job of lopping off the heads that dare to spew their bile here. Too bad it'll grow several new, anonymous ones tomorrow.
JP| 1.27.10 @ 7:58AM
Since we have a third-party pay-as-you-go system of Medicare, there is way out that no one even considers: increases in female fertility rates. However, to maintain the subsides at levels that can pay for expensive late life medical services, couples would need to have on average 5-6 children. When Bismark implemented Germany's first social-security program, the 2nd Reich enjoyed fertility rates of 4.5-5 children per female. Currently in the US, the non-hispanic fertility rate is about 1.7 children per female. That is unsustainable.
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Maribeth Collins| 2.4.10 @ 10:52AM
Kudos to Dr. Rich for actively working to improve a healthcare system that is in trouble and to Jeffrey Lord for helping to bring it to the attention of the American people. Thank you both for your hard work...it's comforting to see people producing alternative solutions that would not drive our healthcare system into the ground!
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NYBroker| 3.22.10 @ 1:28PM
I am an insurance broker, who has spent over 24 years matching the needs of my client with appropriate property, casualty, life and accident insurance products within their budgetary constraints. The fact of the matter is that for both individuals and businesses alike, the budget for health insurance is often much smaller than the budget for other discretionary items like new cars, clothing, vacations, etc. People generally take the attitude that insurance should cost a lot less than it actually does and often have absolutely no idea what the policies cover or don't cover because they only read the policy when the claim occurs. On the flipside the insurance companies only dig in to underwrite the application when the claim occurs. Unfortunately, we have to get to a point where insurance premiums have spiraled out of control for anyone, the state insurance departments and federal government included, to pay attention. The priority for everyone should be to live healthy lifestyles, which is more likely being practiced by those who attend church and volunteer, so there is probably so correlation between those factors and being healthy.
Converse | 8.12.11 @ 3:12AM
is good