Did you know this?

Here is Sen. John Barrasso, Republican of Wyoming, orthopedic surgeon, speaking at the summit yesterday:

What we heard from Senator Conrad is also right. Half of all the money we spend in this country on health care is on just 5 percent of the people. Those are people, for the most part, that eat too much, exercise too little, and smoke. And as a result, we need to focus on those people. So the focus ought to be on the best possible care. People are happy with the quality of care they get, the availability, but they sure don’t like the affordability because it’s not affordable.

Fifty percent of the nation’s spending on health care goes for five percent of the people? And the Democrats want to socialize and transform America because of the health care costs of five percent of the people? Isn’t that insane? Why not just handle the problems of that five percent, and leave the rest of us alone?

Furthermore, if it’s also true, as Barrasso says, that the five percent need all that care because they have taken such poor care of themselves, through excess eating (how many of them are obese and super-obese?), smoking, and lack of exercise, then we’re talking about America sacrificing its freedom, wealth, and well-being for the sake of the most dysfunctional and the least responsible among us. That is evil and insane. Unless you’re a Democrat. If you’re a Democrat, you don’t think that sacrificing the entire country for the sake of its five percent most irresponsible people is evil and insane. You think it’s right and just. You think it’s the highest moral calling in the universe.

Let us remember that Auster’s First Law of Majority-Minority Relations in Liberal Society doesn’t derive from ethnic/racial relations as such, but from the moral inversion at the core of leftism, which affects relations between all “have” and “have not” groups regardless of how they are defined. According to leftism, all people must have equal outcomes, irrespective of deserts. From which it follows that the more dysfunctional and therefore the more needy and more costly to society a group is, the more guilty the society should feel about that group, and the greater its moral obligation to sacrifice itself on that group’s behalf.

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Garrick writes:

This five percent is going to include plenty of elderly who have not abused their health but just need more attention. The slovenly ones who are younger are creating diabetes in themselves and in their children. Diabetes is a skyrocketing part of Medicaid. Junk food diets will give you diabetes and will lower an already low IQ

LA replies:

I simply quoted Barrasso, a surgeon and U.S. senator, and said that if what he said is true, i.e., that “most” people in the five percent group are in that group because of bad habits (not age), then certain conclusions follow.

February 27

Terry Morris writes

You wrote:

“Why not just handle the problems of that five percent, and leave the rest of us alone?”

The short answer is that this so called health care bill is not about helping anyone, it is about power and control. But, of course, you already know this.

Harry Horse, a physician, writes:

Know it? I live it M-F.

The health care debate has nothing to do with the affordable delivery of quality care. It is all about power and spreading the spoils.

On Monday morning, I will return to a Medicare mandated 21 percent pay decrease. Since my overhead is 60 percent (but let’s say 50 percent), I will receive a 42 percent pay cut for my services. I cannot (by penalty of law) charge more to make up for this, cannot stop seeing Medicare (easily, every year I can opt out and then must present myself as a anti-government profiteer to patients who may want my services); since Medicare is the principal of our oligopsony U.S. system (with a 30-70 percent market, depending on your specialty), withing 6-12 months, all private insurances will match this pay cut. True, I can renegotiate my contract, but, again, by law, I cannot collectively organize, thus have no bargaining power.

Because I am a Christian first, the most important priority for me is to glorify God. My work is my mission. As an Internist (doctor specializing in adults, average patient age 72, thus a de facto Geriatrician, and Medicare dependent), I will be forced to make drastic changes or change occupation (what occupation wouldn’t have to with a 42 percent cut). Because of my peculiar outlook (Christian), I never adjusted (as all successful Internists did) to increasing the number of visits/shortening the office visit time. It is now between 7-11 minutes, depending on the office. I insisted on keeping my visits at 30 minutes for follow-up, 60 minutes for new patients. As a result, my patients are happier, healthier, use less expensive medical resources, have less hospital admissions ($$$), have a “medical home,” in essence, everything that ideologues with MDs (ie AMA) pay plenty of lip service towards (but as you see below, seriously dis-incentivized).

What do I receive? Because of my old-school style, I have been informed by the Medicare goons that I am now under investigation. You see, my billing pattern fell outside of the shape of the area histogram, which triggers an automatic audit. Of course, they don’t take into account the gross numbers of individual visits (which for me w/30 minute visits is two SD’s below average), or then fact that I am a tremendous overall deal for them—costing far less, with better outcomes. At my expense, one of my 12 employees has to stop her job, and prepare documentation for the auditors (her usual full-time job is interfacing with Medicare and the associated bureaucracy). It took the auditors, upon receipt of documentation, four months(!) that they didn’t like my signature at the end of my notes, that I would have to certify to its authenticity(!). This is your health care tax dollars hard at work.

I now make less than my wife (a nurse practitioner, the equivalent of a masters). I have 13 years of training post HS), but have never had money so it was always a easy choice for me. My first year of real private practice was my highest grossing (11 years ago), and it has declined every year since. At its zenith, over 50 percent of physicians became Primary Care Doctors (Family Practitioners, Internists, Pediatricians). Now less than two percent go on to become primary Internists like me. Medical students aren’t stupid, why would they, with the average student loan load of 150k at graduation, to boot? It is no secret that my practice has been looking for a physician for six years. We know longer get even CV’s, let alone warm-body interviewees.

Now, with the Monday pay cut, things will get very interesting. A very powerful constituency is going to be finding out what it is like not to have healthcare menservants at their disposal. True that only five percent may utilize, but all seniors are quite aware of the “potential” services available to them.

In summary:

1. We already have government-controlled health care, albeit, indirectly.

2. Incentives for quality are not even being discussed (in my case, they are hectored).

3. Affordability is not even being discussed or organized in a rational manner.

4. Five percent may be true, but it is on almost all seniors radar, and it is about to get very interesting, completely independent of Obama-Care.

Stephen T. writes:

Sen. Barrasso says, “Half of all the money we spend in this country on health care is on just 5 percent of the people.”

Five percent? Wait until the bubble of millions and millions of George Bush’s “youthful, vibrant” illegal aliens from Mexico isn’t so youthful anymore. If there is an immigrant group less inclined to exercise for health and with a greater tendency toward obesity, I honestly don’t know what it is. The intersection of mestizo lifestyle and genes with the availability of fat-laden American fast food has produced huge increases in diabetes, congestive heart disease, strokes, cancer. County USC hospital, the taxpayer-funded HMO for illegal Mexican nationals (no health care summit needed to make sure they get free treatment,) has verified this in reports published in the L.A Times. They note, for example, that Mexican immigrants commonly eat (plus feed their kids) three meals a day at fast food restaurants. Despite the Bush image of mestizo Mexicans as robust, vigorous, salt of the earth types, they are, in fact, usually physical wrecks by age 50. By then they are on disability, addled by hypertension and Type 2 diabetes. In Los Angeles, it is unbelievably rare to glimpse a Mexican woman over the age of 30 who doesn’t look like she would be classified as medically obese by insurance standards.

The sudden disappearance of neighborhood gyms and health clubs plus the dramatic proliferation of entire blocks of cheap junk food places in the 1990s was, for me, an early sign of the Mexicanization of huge swaths of the San Fernando valley. The next sign will be the huge cost to Americans to pay for health care of all their self-induced illnesses plus premature debility in middle-age.

Posted by Lawrence Auster at February 26, 2010 10:32 PM | Send