I’m serious. Read his statements for yourself:
[W]e’re not going to solve every difficult problem in terms of end-of-life care. A lot of that is going to have to be, we as a culture and as a society starting to make better decisions within our own families and for ourselves. But what we can do is make sure that at least some of the waste that exists in the system that’s not making anybody’s mom better, that is loading up on additional tests or additional drugs that the evidence shows is not necessarily going to improve care, that at least we can let doctors know and your mom know that, you know what? Maybe this isn’t going to help. Maybe you’re better off not having the surgery, but taking the painkiller. – “Questions For The President: Prescription For America”, ABC News, June 24, 2009
President Barack Obama said his grandmother’s hip-replacement surgery during the final weeks of her life made him wonder whether expensive procedures for the terminally ill reflect a “sustainable model” for health care.
The president’s grandmother, Madelyn Dunham, had a hip replaced after she was diagnosed with cancer, Obama said in an interview with the New York Times magazine that was published today. Dunham, who lived in Honolulu, died at the age of 86 on Nov. 2, 2008, two days before her grandson’s election victory.
“I don’t know how much that hip replacement cost,” Obama said in the interview. “I would have paid out of pocket for that hip replacement just because she’s my grandmother.”
Obama said “you just get into some very difficult moral issues” when considering whether “to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill.
“That’s where I think you just get into some very difficult moral issues,” he said in the April 14 interview. “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health- care bill out here.” – Bloomberg News, April 29, 2009
All I’m saying is let’s take the example of something like diabetes, one of — a disease that’s skyrocketing, partly because of obesity, partly because it’s not treated as effectively as it could be. Right now if we paid a family — if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they’re taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that’s $30,000, $40,000, $50,000 — immediately the surgeon is reimbursed. Well, why not make sure that we’re also reimbursing the care that prevents the amputation, right? That will save us money. (Applause.) – “Town Hall” meeting in Portsmouth, NH, August 11, 2009
“Right now, doctors a lot of times are forced to make decisions based on the fee payment schedule that’s out there. … The doctor may look at the reimbursement system and say to himself, ‘You know what? I make a lot more money if I take this kid’s tonsils out. Now, that may be the right thing to do, but I’d rather have that doctor making those decisions just based on whether you really need your kid’s tonsils out or whether it might make more sense just to change; maybe they have allergies. Maybe they have something else that would make a difference.” – White House press conference, July 22, 2009
“So, if a member of Congress is carrying water for the drug companies, and says, ‘well, we can’t negotiate for the cheapest available price on drugs because we need the money for R&D research,’ well, we’ll have a discussion right there in front of the American people about the fact that the drug companies do need profits, but they’re also spending a whole bunch of it on marketing, television ads where nobody even knows what the drug is for.” – Candidate forum on health care hosted by the San Francisco Chronicle, 2008
For the last year and a half, President Obama’s arguments in favor of his health care reforms have consisted of little more than recycling every popular myth dreamed up by socialized medicine advocates to illustrate how wretched our private health care system has become:
- “Big Pharma” refuses to price drugs affordably, and instead stuffs money in its own pockets and wastes even more dollars on pointless advertising
- Doctors make medical decisions based on payment schedules, and routinely perform expensive procedures solely in order to line their own pockets
- America needs to be transformed into a more enlightened society that doesn’t spend so much money on expensive, heroic medical procedures for elderly or terminally ill patients
And of course there is the grand-daddy of them all — we will save a tremendous amount of money by mandating regular preventive care, instead of allowing people with health problems to remain untreated until those problems become life-threatening.
What’s worse, President Obama has used these myths as a frequent springboard for Clinton-esque monologues where he appears to simply be making things up as he goes along. After his eye-popping (or was it “fishy”?) claim that amputations are currently more profitable than long-term diabetes management because surgeons are reimbursed up to $50,000 for those operations, the American College of Surgeons quickly issued press release challenging President Obama’s ignorant assumption that foot amputations and tonsillectomies were being performed for profit.
With respect to the preventive medicine myth, researchers at the New England Journal of Medicine concluded in Feburary 2008 that extensive preventive medicine does not always result in net cost savings:
Some preventive measures save money, while others do not, although they may still be worthwhile because they confer substantial health benefits relative to their cost. In contrast, some preventive measures are expensive given the health benefits they confer …
Our findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not. Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical.
Neither the President nor his health care advisers have offered examples of specific preventive treatments demonstrated to be long term cost effective, based on cost analysis of preventive care procedures. It’s probably not a stretch to assume that this is because no one in the Obama Administration or Congress has the slightest clue about which preventive treatments are the ones that will actually save money.
And just last week, CBO director Douglas Elmendorf supported these conclusions by testifying that the preventive health mandates contained in the Congressional health care reform bills would not save money in the long run.
Pharmaceutical advertising is a controversial subject, and there are legitimate concerns about whether or not mass marketing campaigns alter the judgment of both doctors and patients in favor of new, expensive “fad” medications when older or generic prescription medications are just as good. But drug companies also have legitimate reasons to advertise their products, and so far no one has conclusively proven that marketing campaigns by drug companies have directly led to certain prescription drugs being overpriced.
As Kevin pointed out earlier, the Obama Administration seems to be going to great lengths to avoid entering into real debates with educated, savvy experts who hold opposing views. This in spite of the fact that candidate Obama repeatedly promised open, public debates on health care reform.
It’s fair to assume that if an educated intellectual like Barack Obama could simply outline a set of specific basic health care reforms that could be shown to work, he would do it. He should also be able to confidently and rigorously defend his plan in front of skeptics. But because President Obama has chosen to rely on popular myths (instead of documented research) and staged rallies (instead of true debates) to sell his health care reform ideas, one has to wonder about the reliability of any of the broad promises that he has made about health care reform.
This time, Mr. President, your charming smile and Harvard pedigree aren’t going to be enough.
ADDED:
I probably should have included these two additional nuggets of Obama wisdom in my original post:
“We’ve got some work to do. I don’t mind, by the way, being responsible. I expect to be held responsible for these issues because I’m the president. But I don’t want the folks that created the mess — I don’t want the folks who created the mess to do a lot of talking. I want them just to get out of the way so we can clean up the mess. I don’t mind cleaning up after them, but don’t do a lot of talking.” – Campaign rally for Virginia State Senator Creigh Deeds, Aug.6, 2009
“My answer is that if the private insurance companies are providing a good bargain, and if the public option has to be self-sustaining…then I think private insurers should be able to compete. They do it all the time. I mean, if you think about it, UPS and FedEx are doing just fine, right? No, they are. It’s the Post Office that’s always having problems.” – “Town Hall” meeting in Portsmouth, NH, August 11, 2009
Yep — nothing says ‘I’ve lost the issue’ like telling your opponents to stop talking. And I’m sure that President Obama mis-spoke when he tried to use the Post Office as an example of a government enterprise that fosters healthy competition and should be compared to his proposed government health care management system.
He probably meant to talk about AmTrak.
