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Great comedy routine you and the WSJ writer did this morning. ROFL. For those of you who missed it, here's how it went. Obama has a press conference in which he's asked lots of Q's about the Ill. gov. Following the show, Brian asked the comedy writer from the WSJ, "What didn't Obama tell us?" Then the comedy writer from the WSJ rattles off a series of items that the Prez-elect was never asked. Then a caller asked the WSJ guy, why didn't you comment of what Obama did say in answer to questions rather than what he didn't say, and the comedy writer from the WSJ, says with a straight face, and this is the funny part (I'm not making this up), "I just answered the question I was asked." My god, that's funny stuff. Git it. Obama just answered the questions he was asked, and Brian and the comedy writer hit him for not answering questions he wasn't asked. But the comedy writer--this is hilarious--says when he's under fire, "I just answered the question I was asked." I'm rolling on the floor laughing. Great routine. How do you guys think of stuff like this? Funniest show on the air.

"Forgive me in advance, but) People are dying now, just not the right ones."
Nasty! But you are so right in saying this:
"Until middle America begins to see itself as solidly on the losing side of unfettered markets or even marginally regulated markets when it comes to healthcare, the status quo (with curtains) will still be seen as the best way to protect the health and safety of the people. The waterworks, the police, the fire department, the armed forces… Imagine if these were run like big pharma or an HMO."

(Forgive me in advance, but) People are dying now, just not the right ones.
Until middle America begins to see itself as solidly on the losing side of unfettered markets or even marginally regulated markets when it comes to healthcare, the status quo (with curtains) will still be seen as the best way to protect the health and safety of the people. The waterworks, the police, the fire department, the armed forces… Imagine if these were run like big pharma or an HMO.

Voter:
I hear you. I think the German model bears a close look. And I share your pesimism in anything real getting adopted. Maybe you're right and we need a dose of Dickensenian reality. I just hate to see people die for it.

Mc,

I agree. The free-market solution is fraught with problems… citizens would be outraged and people will die… So what? It’s survival of the financially and genetically fittest. One’s God-given abilities, and genetics would determine their future, not artificial markets. Our markets would be free, and freedom is a beautiful (and, might I add AMERICAN) thing.
However, I happen to prefer a little less “freedom”; I was alluding to the German model in my last post. This would seem to be the most perfect system for the United States.
Still, with all the federal government has allowed thus far and with the influence pharma and healthcare have in Washington, I do not see a real solution (even the German one) coming to the United States anytime soon.
(If you’re wondering why I brought up the free-market solution only to be snide, it’s because part of me feels Americans need to taste life under truly free-markets to appreciate the need for having a federal government commissioned with protecting their health and safety.)

Voter:

I hear you vis-a-vis the FDA. Add that it is completely defunded; the studies run on new drugs are financed by the drug companies themselves, and new products are OK's based on how they perform against a placebo, not how they perform against like products.

As to your solutions, the problem with a truly free-market model is that there are always going to be people with serious health problems that no one want to cover. What happens to them? I think a single-payer could work as long as we find a way to control costs. If we continue 6-12% health care inflation we are doomed. There are other countries that have universal coverage and still use private companies, Germany is one.

You know, MC, I don’t know what can be done and that has to do with how extremely complicit the federal government has been creating the mess we have now: The FDA not reigning in direct-to-consumer advertising for prescription drug. Allowing an increase or decrease in dosage or combining two drugs with sunsetting patents to qualify as a new patent. Supporting the notion that proprietary chemical compounds somehow become toxic to Americans once they cross an international border. Practically giving away patents on drugs created with taxpayer dollars at the NIH. Not demanding efficiency and accuracy from hospitals and doctors drawing Medicare and Medicaid dollars. Blaming tort claims for skyrocketing cost while giving short shrift to demonstrative examples of medical malpractice, equipment flaws, and tainted drug studies.
Basically, the federal government has made it its mission to use the private healthcare industry to prove capitalism works to solve social ails.
There seem to be only two tenable solutions. A.) True free-market capitalism where insurance returns to being an actual benefit offered by employers to encourage loyalty and entice be productivity. All others would buy on the so-called self regulating open market. Or… B.) Single payer insurance which is de facto single payer healthcare (since the govt. would effectively monopolize income streams to private industry.) Perhaps there will still be room for a private insurance industry for those wanting enhanced security, but everyone would at least have preventive and catastrophic care.

Re: The Uwe Reinhardt series: Dismal indeed. We have to talk about it sooner or later, though.

Here's a better link to the Uwe Reinhardt series http://economix.blogs.nytimes.com/2008/12/05/why-does-us-health-care-cost-so-much-part-iii-an-aging-population-isnt-the-reason/#more-549

If you're wondering why American health care costs so much, what the breakdown is of costs, and what the potential is for reducing each cost, this series will give you the dismal answer.

Karen #16:
That was a suggestion made, ironically, by the McCain campaign. A pearl amid the rot.

Voter:
You are right about R&D. Advertising costs are much higher for these companies than R&D.

Question: Who should be in charge of controling costs? Do you advocate just paying them without questioning them?

Brian , I had emailed your show yesterday and told you that 1199 in nyc is part of SEIU and thru backroom deals and support 1199 gave the Senator Obama in return I suppose Obama hired one of 1199's VP's Patrick Gaspard to run his washington office now the he has become president and no one has reported on this or made any connection to 1199 SEIU and President-elect Obama.

The scandal is a distraction for the president elect and it is an Illinois issue; however… President elect Obama needs to be held to a high standard, but is the WSJ (under News Corporation) now proposing we hold the future administration to the standard of being accountable for answering questions, not asked, but intimated or feasible when it has not held the current administration to the standard of answering questions explicitly asked?
On healthcare… As the caller said, the real issue is the actual care and not insurance. Insuring astronomical cost will be covered by insurance, without regulating quality of care, access to care (think HMOs dictating treatments), efficacy, or efficient use of funds, does nothing for the people. Despite what doctors, hospitals, and equipment and drug companies say, these cost are not driven by R&D alone.

THANK YOU TRUDY about pointing out that no one is talking about reining in costs at hospitals -- almost one third of the health care bill. Also, Medicare just tried to restrict prescriptions to drugs that have a proven track record against older drugs not just placebos. Congress derailed that effort, led, I am sad to say by the usually excellent Carolyn McCarthy of Long Island.

Good analysis by Uwe Reinhardt on health care economics in the New York Times blogs, http://economix.blogs.nytimes.com/page/2/?scp=1&sq=economix&st=cse

Mr. Lehrer / BL Show Producer,

I understand the need to preempt the stories regarding the split within the Episcopal Church and the Jewish Indian, but please reschedule those segments if possible. They sounded very interesting.

thanks

A larger role for nurse practitioners, physician's assistants, and other para-professionals, as well as for RNs, will reduce costs, particularly re "well child" (i.e., routine) exams and minor illnesses such as colds.

You hit the nail on the head Manny. BINGO!!

Are single-payer advocates one of the stakeholders that will be included?

i've always felt that the key question in all of this is whether or not healthcare is a business or a service (oddly echoing obama's characterization of the proper function of politics).

i think we in this country continue to unequivocally view it as a business. of course if we were to see it as more of a service, this would only be worse for business and the economy.

You just referred to Tom Daschle's comment (in his book) that "the business community" "will not stand for" a single payor health system.

WHY in the name of HEAVEN is it up to the business community to have a voice? ONLY because the current insurance system is worked through employers. Imagine the savings to businesses (especially small businesses) if we get the health care system OUT of business. I suggest we would get the "business" (and scandalous "costs"/profits) out of health care.

What was the total of campaign contributions from the pharmaceutical industry and the insurance industry to the 2008 campaigns?

I think I read it was about $200 million for all campaigns.

Perhaps a minor point, but Blagojevich is bugged using code words like "Senate Candidate 5", while he's spilling his guts about everything else. What a fishy inconsistency...Did he know he was being bugged or what?

The Repubs in Congress always hated the idea of offering a real pharmaceutical plan as part of Medicare.

Norman:
Sounds like Daschle's and Baucus's plan.

And?

I'll connect health care with the Illinois senate corruption.

Billy Tauzin from Louisianna shepherded Medicare Part D through Congress, forbidding the government from negotiating prices with the insurance companies.

Tauzin retired from Congress and got a $3 million/year job with PhARMA, the pharmaceutical industry lobbying organization.

What's the difference? Maybe if the (Republican) federal prosecutors tapped Tauzin's phones he'd be in jail too?

Thank you Trudy for pointing out that no one is talking about controlling costs. 31% of health care costs are hospitals many of which are error prone. We spend almost twice as much as other industrialized countries and have worse outcomes for patients. IT is not going to dig us out of this. Neither will getting rid of insurance companies whose profits and administrative costs add up to 7% the the national health bill.

Does it sound like the President Elect might start shifting the burden of healthcare cost away from businesses in the early portion of his administration?

Daschile's plan requires everybody to buy health insurance, and will give subsidies to people who can't afford it, right?

Another comment: Watch the on-line video of last Sunday's "Meet the Press." When asked about the possibility that Caroline Kennedy might replace Clinton, Obama smiles and answers, "That's a New York issue." He adds, as though as an afterthought "I'm having enough problems with Illinois." My husband and I both heard a note of dissonance in that comment, looked at one another, and asked, "Wonder what's going on in Illinois?"

I'm sure that he knew by Sunday what was going down and that he and his people were not witnesses, targets or "persons of interest."

Many of the listeners to this program favor single payer. How does this relate to single payer?

Will we continue to pay 15% administrative costs to the insurance companies?

Healthcare: First they're going to try to pare down costs, both by vetting the Medicare procedures and bureaucracy, conferring with experts, financial planners, insurance companies and service providers. Then they'll model a program.

The Gov: Obviously, someone in the Governor's office talked to Emmanuel, who blew that person off. Also, Fitzgerald already knows about that contact and isn't bothered by it. The "taint" comment means that Jesse Jackson, Jr. probably won't have Obama's support.