/sarcasm on

Who knew Dr. Drew is selfish conservative for not wanting to provide care to the poor? What a jerk.

/sarcasm off

He's just racist, donchaknow.

/sarcasm

I realize he was making informal comments (the clip sounded like a call-in radio show), but that was a logical mess. First he doesnt know what's going to happen. This is reasonable, since a significant amount of the reform will be implemented at the state level and has not been decided yet.

The idea that will be the same thing that happens "every goddamn time" of physicians and hospitals not being paid leading to doctors choosing to leave the field and hospitals closing doesn't seem to be supported by the evidence. Currently hospitals are required to provide treatment to emergency patients regardless of ability to pay. Reducing the number of uninsured should *decrease* the number of bills which the indigent and uninsured cannot pay, and which care providers currently write off as losses.

Perhaps what he was getting at was not bill payment but Medicare reimbursement. Currently, the federal government sets reimbursement rates for medical services for Medicare patients. This is the "fee for service" program. Physicians and hospitals often complain (with very good reason in some cases) that the reimbursement rates are below their cost of providing these services and in fact there are many providers who have stopped accepting Medicare patients.

I honestly don't understand why so many self-described fiscal conservatives seem opposed to the idea of medical reform. Looking at federal spending over the last few decades, and projected a few decades into the future, it's clear that Medicare and Medicaid expenses are the portion of the federal budget that are growing the fastest, well in advance of GDP growth and inflation. Any serious attempt to restrain the federal budget defecit needs to look at medical expenses as the highest priority.

Attention commenter "Accuracy, Please": Your blogname sucks... It's cloying and condescending without warrant or payoff. You're prissy in more ways than I can count, and it's clouding your logic:

> he doesnt know what's going to happen.

Could it be more obvious that he's speculating, and could it be more likely that he was specifically asked to speculate on the topic of "What's going to happen?"

My favorite critique of Obama (and his administration) is that he's never created any wealth.

He's never taken something that was worth X number of dollars, and improved it to the point where someone would pay X + 3 dollars for it.

His whole life, when he's needed money, whether for his own glorious education or for his community organizing, all he's had to do was get on the phone and ask someone to send it over. That's how he thinks it works. He thinks if people are poor, it's because they have no one to call. He thinks money is conjured.

It's this same thinking that gives some people a boner when they hear the word "insurance":

> Reducing the number of uninsured should
> *decrease* the number of bills which the
> indigent and uninsured cannot pay, and
> which care providers currently write
> off as losses.

You presume that the fees government will pay for medical services are the ones that medical people want to be paid, and this is not even close to correct.

But more to the point, you seem to imagine that insurance pulls money out of thin air... When actually it's nothing but a wager, a shuffling of resources for mutual benefit of the insurer and the insured.

MUTUAL! MUTUAL! MUTUAL! Read that until you get it.

To say simply that people are "insured" says nothing about the creation of the wealth that pays for their care. And it certainly has nothing to do with what that care means to the people who provide it.

> Any serious attempt to restrain the federal
> budget defecit needs to look at medical
> expenses as the highest priority.

Then why, for fuck's sake, are you prattling on about "insurance"?

Well said Crid.

"I honestly don't understand why so many self-described fiscal conservatives seem opposed to the idea of medical reform."

It is hardly medical reform to put a legal gun to my head in the form of taxes to make me buy a private product, a scheme that will ultimately lead to single payer as private companies go out of business. What happened to "my body, my choice"? Apparently that only applies to reproductive rights.

Government interference is the cause of a lot of the run away medical costs. I'm not against reform but getting the government more involved isn't the answer.

I agree that what's happening isn't "reform", it's injecting more government into something that has enough problems already.

If you had a true building Medical Spending Account (MSA) that you could contribute to for days, months, years -- your deductible was the MSA.

If the consumer knew he could get the non-
emergency MRI at Wal-Mart for $250 instead of paying the hospital $1000 -- what do you think would happen?

It would shift the whole system. Insurance has shifted the paradigm into thinking "I'm not responsible for the bill, why should I care of the cost?"