Republicans attack healthcare nominee over his love of NHS

staff ^ | 6/2/10 | staff

[Nachum]

A visionary American academic is at the centre of a new battle over the future of US healthcare because of his fervent admiration for the National Health Service in Britain.

Donald Berwick, a Harvard-trained paediatrician and founder of a leading health policy think-tank, is being attacked by Republicans who could block his involvement in the enforcement of President Obama’s hard-won health reforms. His sin? To admit that he “fell in love” with the NHS.

When Professor Berwick was chosen by the White House to lead America’s biggest state-run health provider, his nomination was expected to sail through Congress unchallenged. Mr Obama’s health reforms appeared doomed, and the previous two heads of the Centres for Medicare and Medicaid Services (CMS) had been approved without so much as a formal vote.

[ExTexasRedhead]

It’s DeathCare and it has nothing to do with health in my opinion.

[darkangel82]

It definitely doesn’t. Berwick is a nutjob.

[ExTexasRedhead]

Everyone in this Regime must come out of a mental ward. Remind you of the hiring practices of the Gestapo?

[darkangel82]

Yep.

[caper gal 1]

And we should want to emulate any European economy because . . . ? Our health care system worked fine prior to the government intervention beginning in 1965. My blue collar parents took out their wallets and paid for medical care without health insurance. The gargantuan middle-man industry of bean counters and shake down artists that have resulted from that gov’t intervention, including torte lawyers, is what has made the cost unaffordable.

[pieceofthepuzzle]

“The gargantuan middle-man industry of bean counters and shake down artists that have resulted from that gov’t intervention, including torte lawyers, is what has made the cost unaffordable.”

That's part of it. There's also the cost of innovation and advancement. If we were still routinely bleeding people as a form of treatment costs wouldn't be too high.

[caper gal 1]

That's a straw argument. Recently I was cleaning out my mother's apartment and found a document which perfectly illustrates this. In 1968, just three short years after LBJ’s government got in the health care business, my father was attacked by and beaten severely with a tire iron. He spent a week in ICU and had surgery to remove portions of his skull, and a second surgery to put plates in to replace those portions.

He worked as a maintenance man at a manufacturing plant, and my mother was a nurse. The document is a claim they filed against his attacker to be reimbursed for the medical expenses they had paid. The total bill for ambulance, two hospitalizations, surgeries and drugs? $1,168.52. They paid it out of pocket. They didn’t have health insurance. They didn’t need it because health care at that point was still market based. Adjusted for inflation to current dollars that bill would still be only $7,155.13, far less than you can rack up today in less than an hour in your local ER.

[caper gal 1]

That's a straw argument. Recently I was cleaning out my mother's apartment and found a document which perfectly illustrates this. In 1968, just three short years after LBJ’s government got in the health care business, my father was attacked by thugs and beaten severely with a tire iron. He spent a week in ICU and had surgery to remove portions of his skull, and a second surgery to put plates in to replace those portions.

He worked as a maintenance man at a manufacturing plant, and my mother was a nurse. The document is a claim they filed against his attacker to be reimbursed for the medical expenses they had paid. The total bill for ambulance, two hospitalizations, surgeries and drugs? $1,168.52. They paid it out of pocket. They didn’t have health insurance. They didn’t need it because health care at that point was still market based. Adjusted for inflation to current dollars that bill would still be only $7,155.13, far less than you can rack up today in less than an hour in your local ER.

[caper gal 1]

Corrected the “by thugs” so mal contents wouldn’t pile on that my father was attacked by a tire iron. It’s late, folks.

[pieceofthepuzzle]

Yes, but back then all surgical instruments were sterilized and reused, as were surgical drapes etc. There weren’t advanced CT scanners and MRI scanners. The monitoring equipment in the emergency room and the ICU was not modern digital equipment, and there were many fewer drugs available. That’s just a start. But yes, there are also dramatic changes that are due to bureaucracy and lawyers, no doubt.

[caper gal 1]

Still not buying your argument. A week in ICU and 2 neurologic surgeries would likely run close to or more than $200,000 today or more. Not enough to offset your argument. The new technologies you mention actually have reduced medical costs because they have eliminated a phrase from our lexicon, that of "exploratory surgery" which is no longer necessary.

[Gapplega]

I’d say, you get what you pay for. The outcomes in a modern ICU are much better than those achieved in the 60s.

However, as an oncologist, i see questionable new drugs that prolong life only a few months, but cost almost $100K. No society can afford that. Example number 1: Provenge.

[pieceofthepuzzle]

I'm a doc, and I've watched technology dramatically advance over the past 20 years, in multiple specialties. For example, If you presented to an emergency room with a myocardial infarction (MI = ‘heart attack’) in the late seventies to early 80s you would get morphine, nitroglycerin, and be put into the ICU with the hopes that you would survive. A few people would go for emergency bypass surgery, which didn't stop the infarction very quickly (takes time to get an OR ready, chest open, etc.) and cost a fair amount of money, even then. The rest, if they survived, would get an angiogram at some point and maybe get bypass surgery.

Then there was the development of thrombolytic drugs (clot busters) that could open a fair percentage of acutely occluded vessels and thus stop a heart attack. These were initially marketed at thousands of dollars each dose. Then came the development of angioplasty for MI, then the use of stents for MI. Stents were marketed at several thousand dollars each. The drugs used to prevent them from clotting were/are expensive, and to have a program that is ready to perform angioplasty acutely on anyone with an MI night or day costs a lot of money to keep running (technical staff and nurses on call; expensive equipment, etc.). I could go on and on. There is most definitely a contribution of technological advancement to medical costs.