Friday, August 7, 2009

Charles Krauthammer making sense!?!?!?!

Ol' Chuckie K has a terrific piece in the WaPo today on his ideas for healthcare reform. I had to rub my eyes reading it. Instead of spewing neoncon right wing gobbledygook, he actually produces a substantive effort here. And it's about time. I think we're all tired of hearing Obamacare demonized as "socialism" and a "rationing" by the right without the concomitant promulgation of a reasonable alternative strategy. The more the GOP rants about "killing granny" and bureaucratic death panels that will decide whether or not babies with Down Syndrome get health care, the further they fall from the realm of credibility. Here are the specific elements of an alternative plan:

1)Tort reform- It's a travesty that nowhere in HR 3200 will you find anything addressing the costs and waste of our ludicrous med mal system. (And yes, the AMA signed off on this boondoggle without demanding some form of rectification of our Wild West malpractice system.) Trial attorneys will say, malpractice payouts represent but a fraction of total health care spending. And it's a totally disingenuous retort. What about defensive medicine? Why are we ordering unnecessary MRI's and CT scans and getting cardiology consults on 25 year olds with chest tightness? Is it because doctors are greedy (watch those tonsils!)? Or just plain stupid? No, of course not. Docs are just trying to collectively cover their asses. Here's Krauthammer:
What to do? Abolish the entire medical-malpractice system. Create a new social pool from which people injured in medical errors or accidents can draw. The adjudication would be done by medical experts, not lay juries giving away lottery prizes at the behest of the liquid-tongued John Edwardses who pocket a third of the proceeds.
Reform med mal and we'll save billions. Just you watch.

2)Tax employer-provided health benefits and return the cash to individuals in the form of a tax rebate that they can use to purchase their own coverage. No longer will one feel beholden to a job one loathes because of the benefits. This one doesn't light my fire the way tort reform does (you still need a job that offers benefits in order to qualify for that rebate). And those without jobs will still be essentially "free loading" off those who are fortunate enough to have a gig with benefits.

So all is not perfect. But it's a start! At least the right is starting to creep into the light of rational discourse. There's hope yet.


Anonymous said...

Just a little free "street smarts" to the people. When a political party counts on its Lunatic Fringe to represent in large numbers for photo ops, it's a bad thing. And yea, it's also a bad thing to have a large Lunatic Fringe.

Lunatic Fringe, you don't want to belong to any group whose primary intention is to take advantage of your ignorance and lack of self control. You were called and asked to show up because you are on that list of village idiots they pass around -- never got that free TV they promised ya, huh. You knew you were gonna make an ass of yourself in public (you always do). So, stay home next time.

-SCNS (in a bad mood)

Anonymous said...

I think that some tort reform is needed and could have some effect; but I don't think it would hit $1B let alone multiple billions worth of dollars.

I've worked in healthcare for about 7 years doing ultrasound. During that time my state passed tort reform and is now graded an 'A' in med mal by ACEP. Did defensive medicine go down? Not noticeably. And in fact to talk to physicians here you wouldn't know that we have one of the most physician friendly tort systems in the country. It's like until the day they can't be sued they won't be happy.

Unnecessary imaging exams (for example) are not just used for CYA; they are used by physicians that don't want to come examine their patients after hours. Imaging becomes the de facto physician extender for in-hospital care.

Macha said...

You are aware that Krauthammer is an MD?

Nick Dupree said...

Anon 11:28 AM is right. As Atul Gawande has pointed out repeatedly, two of our biggest states—California and Texas—severely capped malpractice awards a few years ago and nothing has changed there. But who cares? Why not focus on the reforms that'll have the least effect? It sounds good.

Phalanx said...

Nick, I would say that's only an argument that malpractice caps don't work, not that medical courts wouldn't.