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Former Medicare Chief Donald Berwick Speaks

Dr. Donald Berwick hit the buzzsaw of American politics as short-time chief of Medicare. Now, he’s out, and talking.

Medicare Administrator Dr. Donald Berwick gestures during an interview with The Associated Press, Tuesday, April 12, 2011, in Washington. (AP)

Medicare Administrator Dr. Donald Berwick gestures during an interview with The Associated Press, Tuesday, April 12, 2011, in Washington. (AP)

Dr. Donald Berwick has spent his life working to make American health care cheaper and better. Then he went to Washington, and ran into the buzz saw of American health care politics.

Barack Obama appointed Berwick chief of all Medicare and Medicare, health care providers for one out of every three Americans. The giant item in the federal budget. But it was a recess appointment. It needed the Senate’s stamp of approval. Senate Republicans would not give it.

Now, after seventeen months, he’s out.

This hour, On Point: Donald Berwick on American health, health care, and buzz saw politics.

-Tom Ashbrook

Guests

Dr. Donald Berwick, administrator, until last Thursday, of the Centers for Medicare & Medicaid Services (CMS), which provides healthcare for 100 million Americans. Former President and Chief Executive Officer of the Institute for Healthcare Improvement, a not-for-profit organization focused on healthcare improvement

Highlights

Despite stepping down as chief of America’s Medicare and Medicaid programs, Dr. Donald Berwick said it is a “thrilling time in health care.” And he said now is the time for change:

“On the one hand I do think we can buckle down as a country and get health care to perform the way we all want it to with dignity, reliability and safety,” Berwick said. “The problem is that a lot of people don’t understand that possibility. They don’t understand that health care can get a lot better.”

Berwick says that he was interested in the ways that corporations remain competitive and noted that “constant innovation is the root of making things better and more affordable and that is true of health care.”

He explained that his departure from Washington was due to the absence of “authentic dialogue’ about what is needed and what is possible. “Everything has been reduced to sound bites and rhetoric,” Berwick said. “It was really hard to engage as I would have wanted to engage with some people who have some skepticism about the law about what the possibilities are.”

On the question of redistribution of wealth and health care benefits, Berwick explained that “insurance is redistribution.”

“It is simply a fact that illness and poverty go together. Wealth and health are inversely related,” Berwick said. “If we want to become a country in which if you get ill you get care then we saying that those of us who have more because we are healthier are going to help those of us who have less because we are not going to need the help of others. That is really the moral question for the country: do we help each other with our health.”

From Tom’s Reading List

The New York Times “Mr. Obama first nominated Dr. Berwick in April 2010, but he never received a Senate confirmation hearing. More than 40 Senate Republicans urged the White House to withdraw the nomination last spring, and many vowed to block confirmation.”

Healthaffairs.org “As he ticked off to his aides the various stakeholder groups he wanted to check with that day, he was startled when one informed him that Libyan dictator Muammar Gaddafi had just been reported killed. He and his press officer safely predicted that this stunning news undoubtedly would trump the ACO announcement.”

Washington Post “It’s a rare moment in an increasingly polarized Washington: One of the highest ranking Republicans endorsing the bureaucrat that the Obama administration hopes will oversee implementation of its health care law. But when we spoke this morning, House Majority Leader Eric Cantor was resolute in his support for Marilyn Tavenner, the woman the White House hopes will oversee the Center for Medicare and Medicaid Services.”

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  • Yar

    Kentucky is a state that CMS built.  “For every dollar Kentucky sends to Washington in federal taxes, it gets back between $1.51 and $1.82 in federal spending, depending on which study is consulted. Other states — mostly in the Northeast and Midwest — subsidize Kentucky by paying more in taxes than they get in return.” Thank you Massachusetts.http://www.kentucky.com/2010/05/16/1266910/kentucky-tsks-but-takes-federal.html#ixzz1fkGsPEaO   Much of this comes directly from CMS

    I worked in a MHMR facility that lost CMS funding, a loss of nearly 70 million dollars per year, it nearly brought our state’s budget to its knees, and that was just the cost of caring for fewer than 200 residents (clients) while directly employing around 850 people.  
    In the golden triangle, from Lexington to Louisville to Covington (near Cincinnati) the economic engine runs in large part on medical dollars, much if not most directly through CMS.  
    Isn’t it ironic that Mitch McConnell (R) and Rand Paul (R), our two state senators support cutting CMS.  Rand Paul is an eye surgeon, and his practice involved CMS dollars.   
    Yesterday, Niall Ferguson said on this show that our current healthcare model will do in the West.  If he is correct, Kentucky will be among the first states to fail.  How do we move to a model of universal healthcare that we can afford, and what will these changes do to poor states like Kentucky?  How do we make our citizens take better care of themselves, while protecting or most vulnerable?   KY is insolvent if Centers for Medicaid and Medicare Services funds are removed. 

    • JUST CORY PLEASE!

      Rand Paul and Mitch McMarbles, ey Yar?  You must feel the same pride I do in Wisconsin with Plastics magnate Ron Johnson and good ole Scotty “the unionbuster” Walker. 

      I work at a non-profit hospital, and we are already starting to feel the constriction of likely medicare cuts.  Can’t wait til it ACTUALLY happens.  Decline indeed. 

    • William

      Why do people stay in Ky if it is not creating jobs?. Does it make economic sense to support people that don’t want to face the facts of life and move to where the jobs are?

      • Yar

        Some do leave, but where do poorly educated and disabled people find a livable place in a lean-mean society?  This economy has left many at the alter.  Some turn to escape in drugs, including alcohol.  Some have put false hope in gambling, like the lottery, but many (most) have turned to family and subsistence such as farming as a means to survive.  Where would you have them go?   It is easy to make a society work if you simply ignore the leftovers.  Isn’t that what conservatives want?  Privatize the profits and pass the liabilities off on someone else.  (Let the church support the poor instead of raising taxes.)  Instead of asking why are you still here, why not ask what needs to be done.  We need energy efficient housing, we need public transportation, we  need better education. Can we afford not to invest in our community?  Many of the armed forces come from places like Kentucky, if people that live in our state don’t have a place in our society, they will lead in the revolution.  And as Niall Ferguson said yesterday, change is not always gradual.  It is often in the form of collapse. Kentucky has a long history of a dark and bloody ground.  The 38 parallel has been fought over around the world.  It is as far north as a southerner wants to live and as far south as a northerner wants to live.  It is a wonderful place to live, only it is hard to make a living.
        As a nation we have a huge population entering their senior years with negative net equity, one in three will need long term care assistance.  William, you ask an important question, “Why”!
        If you were in charge, what would you do?

        • William

          Many people move due to economics. It is just common sense. Why stay in an area that just does not generate enough jobs? At some point people have to take ownership of their lives.

          • JUST CORY PLEASE!

            Know where I can get a cheap Bedouin style tent?  I’ll wait to purchase a camel until after I get my new Walmart job three states away…

          • William

            Check Craigslist

          • railroad bill

            self reliance is good for sure, and initiative, W, but aren’t some of your neighbors a bit more limited or less resourceful than you? also, what if they move from Kentucky to China or Malaysia to get a job – and produce those cheaper/better products that out-compete US products…

      • Anonymous

        Social Darwinism is not the answer if you want a just society. Move to where the jobs are is your solution. Maybe you should read the Grapes of Wrath to get a perspective on that ideology.

        • William

          Actually, “moving to where the jobs are” has been going on since we moved from a farm based economy to an industrial based economy. Nothing has changed, but still, we have people that won’t face reality and move.

          • Anonymous

            Not everyone can move for a lot of reasons. This is not a recipe for success.

          • William

            The recipe for failure is to not help yourself. Moving is not a new idea.

          • Anonymous

            @0aeb1c67f759dc0e24a92a5eb0bf6a0b:disqus @jeffe68:disqus @Yar_From_Somerset_Ky:disqus 
            So just move to Texas and get a minimum wage job in a state with a RISING unemployment rate (over 8% yet?) and that will fix everything.

          • William

            No, move to ND and get a job in the booming oil industry.

          • JUST CORY PLEASE!

            The reality you describe?  Deny all family and attachment and move with the wind and tides of the economy.  I’d rather live at the local lockup where at least I could be easily visited by family and friends.

          • William

            Economics is just unfair. Don’t you wish Obama would go after economics and make it fair. The mere thought of people having to go to areas that actually produce jobs seems so unfair.

      • JUST CORY PLEASE!

        Because they don’t want to be nomadic?  They have family and friends and attachments?

        The facts of life?  Does our existence have to be ENTIRELY defined by our employment.  It is the true definition of a conservative hell.

      • TFRX

         Uh, moving costs money? Are you so missing the 1930s that you want to recreate the Grapes of Wrath with Kentuckians instead of Okies?

      • Terry Tree Tree

        Pretend you are NOT rich, made $8. per hour, have a family, a house you are paying for, along with your five-year old auto, you can just pull up stakes, and MOVE your family and house to where you can get another $8. per hour job?   YOU can do this, in this economy, with the jobs competition this stiff?  One-wage-earner?

        • TFRX

          And when you get there, they’ll welcome you with open arms. Just like Tom Joad.

          I’m sure William has plenty of “reasonable” questions about why the lower strata of New Orleans didn’t leave before Katrina hit.

          • William

            The lower “strata” of NO did not leave because there were raised to trust Democrats would save them, which turned out to be wrong.

    • http://freeourfreemarkets.org Steve Banicki

      As a nation that was founded by mostly Christians, one of our core principles is that it is a morale obligation of those that have been blessed with superior talents and gifts to help the needy. This includes providing basic health care to those who are in need but not in a position to afford it on their own. Christianity is not the only religion that preaches this belief. One of the basic Pillars of Islam as stated in the Koran is Giving Zakat which means ‘giving a specified percentage on certain properties to certain classes of needy people. 

      Our core value of helping our neighbor is why we needed to improve our health care system. Now we must decide what is the best way to do it. Another reason is that it is presently inefficient. The government is not protecting the free market to allow it to contribute to the solution..Lord Acton, the British historian, said in 1887; “Power tends to corrupt, and absolute power corrupts absolutely. Great men are almost always bad men.”
      Read More:  http://bit.ly/oA9LUi

      • railroad bill

        also, the Obama/Berwick ACA ideas behind improving healthcare include cutting the costs significantly: for example, better surgical processes reduce infections which reduce continued or additional care and re-hospitalizations – less cost for all of us citizens!  A very good thing on both ends, better quality care resulting in lowered costs. A good mantra for any industry concerned about providing real value. An essential path for our society and all the good people on both sides of the politics & philosophies.

  • JUST CORY PLEASE!

    What percentage of the elderly can afford their health costs without the suppoort of a robust and effective Medicare program?

    If we decide we cannot afford Medicare in a serious way anymore, what do we do with those who cannot?

    Your answer to these questions says a lot about you.

  • Roy Mac

    Eric Can’ter?  Thought that was Boner’s title…

    • Terry Tree Tree

      A LOT of CAN’T-ers in the Republicans!!  Except to fill their pockets!  Yes, they CAN do that!!

  • RolloMartins

    How about solving our health care problem with Medicare-For-All, paying for it with the 250 billion dollars a year saved, and covering everyone. Oh, and there’d be money left over. Nah. Let’s just keep doing the same old thing.

    • Yar

      Wasn’t that what candidate Obama stood for? Isn’t that what the for profit healthcare industry has fought tooth and nail?  I would at least require insurance companies to maintain an electronic health record available to clinicians.  I would pay for healthcare with a 10 percent VAT.  It is regressive, but less regressive than the current healthcare funding system.  We can have the best Health care system in the world using only 10 percent of GDP. 

      • Anonymous

        I just had a check up and this subject came up with my GP. He supports the idea of Medicare for all and is extremely disappointed with President Obama’ lackluster leadership. We both agreed that the future of health care and insurance is pretty grim. That as a nation we will never have a national health care system.

        I keep using the term social Darwinism but that’s what the GOP and the tea party want, the race to the bottom will be paved with the displaced and those who are just not lucky enough to be well off. 

        • Yar

          I am not sure they even know what they really want, other than for someone else to pay for it.  Their businesses depend on the money that our government returns to the community.  Without it the pot will boil dry pretty quickly.  That was the point I tried to make in my first post today.  Then who will buy their goods and services, who will pay the cop to defend their shops, who will teach the children?  They know the system is broken, but like an addict who’s next fix is a campaign contribution, they don’t have the will to change.  We must provide the change they need, when the people lead, the leaders will follow, eventually.  

          • Anonymous

            I agree. Not one person has become wealthy in this nation without the help of others and the taxes we all pay into the system.  The problem that I see is that our government is very dysfunctional and that the partisanship problem is so huge that nothing gets done.

        • Anonymous

          @jeffe68:disqus @Yar_From_Somerset_Ky:disqus @528e7ff84f6189c68a95c4fc543725be:disqus I agree that a public option would have been a great thing. But remember, and I paraphrase Will Rogers who once said that he was not a member of a party, he was a Democrat, a group that is totally disorganized.

          Just remember the fate of Clinton’s health plan. Obama at least got some GOOD reforms by letting the wildcat Democratic Senators battle each other for some TEN months to find THE SOMETHING that COULD pass. Also the Democrats only had a 60 vote majority for some 5 months opf that period.

          Note also that this stretching out of legislation process delayed other legislation and killed the appetite for senators to pass climate legislation. A Democratic Senator admitted that settling on the PPACA took much too long.

          But maybe that was necessary with the moneyed interests fighting ANY substantial change.

          • Yar

            While the Democratic party is organizationally challenged,  the Republican party is ethically challenged.  Which party would you rather support?  I don’t think the ‘right to exploit’ should be an American value.

          • Anonymous

            @Yar_From_Somerset_Ky:disqus  I didn’t think I was arguing against supporting the Democratic Party, just arguing that it is far from perfect and unlikely to give the country everything it needs, at least without campaign finance reform.

          • Terry Tree Tree

            Actually, didn’t Will say he was not a member of an organized political party, he was a Democrat?
                Thanks for the reminder of SOME of the long fight, since President Truman, for a National Health-care plan!  How many people have we lost NEEDLESSLY?  How much national treasure has been wasted?  How much production LOST?   How many executives and Board Members got WEALTHY?

          • Anonymous

            @fa0bc679d4cba4c097672d7e5c15d631:disqus  Thanks for getting my paraphrase straightened out!

          • Terry Tree Tree

            Welcome!  It IS a classic, and too true about the party that tries to do the most for the most, instead of the MOST for the few attitude of the right(?), that seem so wrong!

    • JUST CORY PLEASE!

      It’s a great idea.  All we have to do is deport all of the conservative Americans and the right leaning independents. 

  • Anonymous

    The problems with Medicare don’t necessarily stem solely from internal factors: the healthcare system which is a combination of a number of many sectors: insurance companies, hospitals, pharmaceuticals, medical supplies and equipment, healthcare education, doctors, nurses and other healthcare professionals, and other health care institutions. Insurance companies, big pharma, and hospitals at the core have developed extraordinarily inefficient modalities ingrained in their systems and culture that conspire to yield one to the most inefficient, ineffective and expensive healthcare delivery systems on the planet.
     
    We need reforms but not based upon ideology and not based upon the economic interests of the captains of industry who own Congress; those interests who delivered to us a greatly flawed healthcare reform bill that served their interests not ours, with many aspects that are sub-optimal from the perspective of efficient and effective delivery of healthcare.
     
    Reforms need to be based upon facts, models and modalities that have demonstrated success, but these are at odds with the immediate interests of those wealthy puppet masters. I see this as the greatest problem with healthcare reform: congress as an institution has not adapted to meet the needs of The People; it has been corrupted by the money of amoral industrialists and power brokers.
     
    This is just another example of the shredding, thread by thread, of the of the fabric of society that binds us together,  from which we have gained strength, leaving us dizzy, wheezing and weak as a by-product of the selfish machinations of elite industrialist puppet masters.
     
    What ever happened to E Pluribus Unum and United We Stand?

    • Yar

      MadMark, you are correct.  If I could only make one change in our health insurance system, it would be to require the total cost of health insurance show on the pay-stub.  It is an earned benefit, all earned benefits should show on your pay-stub.  Measure what you want to change!  This simple change would put tremendous pressure on the healthcare delivery system to increase efficiency.

    • Anonymous

      @MadMarkTheCodeWarrior:disqus I like what you said, but I think we all have to take the good while we wait for the best. If we just wait for the best, it may never come. and I believe that the PPACA is not totally in the wrong direction but is tacking back and forth like a sailboat going upwind. If you want get more change faster, you need to change the direction of the wind, which can only be done by changing the current campaign finance system. For that, see Lawrence Lessig’s program.

      As I said in my comment above, this plan, with all of its weaknesses, WAS undoubtedly the best achievable at this time. And to achieve that best took a huge effort that only this approach by Obama could have gotten. I am not sure even a Lyndon Johnson could have done better, and he is certainly the “gold standard” in getting legislation through Congress. But this whole thing shows just how good Nancy Pelosi was as Speaker and why she is so reviled on the right.

      • Terry Tree Tree

        Yep!  Ol’ Lyndon knew how to twist arms, and use skeletons in the closet!  I thank him for Medicare, and Equal Rights!  I do NOT thank him for the Vietnam WAr, the cover-up of the Kennedy killings,taking money from Social Security,  and a lot more!

  • Newton Whale

    This is yet another example of how profoundly undemocratic the Senate is.

    Berwick’s appointment was not voted down in the Senate: he never got a hearing because Republicans had enough votes to filibuster him.

    There is nothing in the Constitution that provides for a filibuster: it is completely a matter of Senate rules, which can be changed.

    Too much criticism of government is unfocused and unhelpful. “The government is broken” does nothing to suggest a solution.

    Get rid of the filibuster and you’ll make government more accountable to the majority of voters overnight.

    • TFRX

      Wasn’t it not too long ago that the Evening News could be relied on to chant “UpOrDownVote!UpOrDownVote!” like a parrot?

      Whatever happened to that slice of our media uberlords?

    • Anonymous

      @d1f4d6bdbd30038a190115b7f587a2c9:disqus There was a lot of talk around December of 2010 about Democrats changing the filibuster rules, but the desire to be able to prevent bad legislation when the “other side” regains control, as it inevitably will, prevailed and no majority for reform was achieved. But the abuse of the filibuster is a modern Republican development. And Democrats will undoubtedly never achieve the level of use that the Republicans have.

      Therefore, the real hope for a more productive Congress is campaign finance reform, by a Constitutional Convention, probably along the lines being developed by Lawrence Lessig of Harvard.

  • http://freeourfreemarkets.org Steve Banicki

    As a nation that was founded by mostly Christians, one of our core principles is that it is a morale obligation of those that have been blessed with superior talents and gifts to help the needy. This includes providing basic health care to those who are in need but not in a position to afford it on their own. Christianity is not the only religion that preaches this belief. One of the basic Pillars of Islam as stated in the Koran is Giving Zakat which means ‘giving a specified percentage on certain properties to certain classes of needy people. 

    Our core value of helping our neighbor is why we needed to improve our health care system. Now we must decide what is the best way to do it. Another reason is that it is presently inefficient. The government is not protecting the free market to allow it to contribute to the solution..Lord Acton, the British historian, said in 1887; “Power tends to corrupt, and absolute power corrupts absolutely. Great men are almost always bad men.”
    Read More:  http://bit.ly/oA9LUi 

    • Terry Tree Tree

      EXCELLENT!

    • Anonymous

      @sbanicki:disqus The “problem” with a person’s health is that the costs of maintaining it are not evenly distributed. Due to a person’s genes and that part of the environment the person encounters, which are totally unknowable by the person in advance, 80% of the costs are incurred by only 20% of the people. These costs are not self-insurable by any but the richest among us. But those few refuse to consider this and resent paying “for someone else’s problem.” This feeling among the young that they are immune leads to rejection of buying insurance, at least until they “need” it.

      It comes down to people thinking they were the sole reason for their success in life, with no help from, or duty to, others, those who either helped them or those just less lucky in life.

    • Terry Tree Tree

      Don’t ‘compassionate’ ‘conservatives’ claim to be ‘Christian’?  Shouldn’t they just say they are HYPOCRITES?

  • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

    Medicare will be with forever but less reimbursement. If Medicare and Medicaid fails it is the end of America.

  • JustSayin

    Primarily there is more than enough money in the system if it were structured properly.

    Any system that hides the cost from the consumer is doomed. If the patient is to be the primary safeguard of cost control (like the rest of the economy), how do they do it if they never know who billed, and for what.

    The first goal of controlling costs is to actually KNOW what things cost. If you don’t think this is true ask your doctor what procedures and tests cost. They have no idea… The doctor is a salesman, who sells a product, and neither the patient or the doctor discuss prices? Many times the patient never even receives a statement for what was billed to the system.  

    Its not crass ask the price, because it actually does have a cost when billed. To begin a price controlling structure begin with co-pays. EVERYTHING should have a co-pay even if its a few dollars to get the consumer to begin thinking about cost and the all important, is this even necessary question.

    Every party in the service chain should receive the same statement of charges to protect the consumer and medicare. These documents provide a document trail for fraud investigations.

    Just imagine how much food would cost if it operated on the same model. You go to purchase food, and nothing has a price, but everything you purchase will be billed to the taxpayer, and you leave with no receipt.

    How much corruption would be created by a purchasing system like that?

    • Anonymous

      @eb6e941afefc55d914e933031fc4b98a:disqus  Seeing the bill is fine as far as it goes, but when one is confronted with pain and prospects of death, it probably won’t do that much if the doctor doesn’t know of alternative approaches. When doctors have drug salesmen in their office selling the latest “improvement” but no statistics on how much better (just relative to a placebo, not other drugs in use) it is, they have no way of choosing the least expensive and most effective path to recommend. And what patient has the time and skill to determine a good approach to his condition without doctors that can lead the discussion. Doctors are there because they have spent their lives learning these things; if all they can do is choose the “latest thing” the costs will go up much faster than the patients’ income.

    • Anonymous

      I do this when I get health care.  Nobody, and I mean nobody, involved in the process, knows what the service they are providing costs. 

      It’s similar to the fact that almost nobody with employer-provided health insurance has any clue about what it would cost them on the free market to replace that coverage. 

  • http://pulse.yahoo.com/_SDKEES3YIJ7KO3CDLFV2GMKBHE Richard

    It is amazing to me that labor groups whether private or public have not embraced and advanced Dr Berwick’s triple aim of quality care, healthy populations and cost.  We have just gone through another decade where medical costs have doubled.  Many economists say that we will not be able to afford, for the average working class family, another decade like the last decade. Shifting costs to the subscriber does not ensure that we are achieving “better outcomes”, “healthier populations” and “cost containment” which can only be achieved by “best practice” medicine and healthier lifestyles whch Dr Berwick has as a stated goal. Dr Berwicks dismissal is the result of ordinary working class groups and their employers who have refused to believe that there needs to be changes in our healthcare system so that any money spent is delivering care that improves our health. 
    I would add that I am disappointed with Pres Obama’s lack of leadership in promoting Dr Berwick’s goals.  You read through Berwicks’ beliefs and there is a lot of common sense that anyone can understand. 

    • Anonymous

      @yahoo-SDKEES3YIJ7KO3CDLFV2GMKBHE:disqus When the problem is getting a bunch of “stars” to agree on something, dictating to them is usually not productive; letting them think they have done it themselves although you have provided the right “nudges” at the right time can be much more effective.
      This is what “community organizers” learn and how “leading from behind” work, and it is not to be disparaged, particularly in these difficult times when the “command and control system” does not work well. The President can decree, to some extent, within the Executive, but not easily in the Legislative.

  • Newton Whale

    This is why Republicans say if they don’t get rid of Obamacare now they never will‏:

    ‘Obamacare’ to the rescueA woman who felt President Obama had let the middle class down has changed her mind.I want to apologize to President Obama. But first, some background.

    I found out three weeks ago I have cancer. I’m 49 years old, have been married for almost 20 years and have two kids. 

    We’re good people, and we work hard. But we haven’t been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.Fortunately for me, I’ve been saved by the federal government’s Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It’s part of President Obama’s healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate (nothing like the people I have dealt with over the years at other insurance companies.) It’s not perfect, of course, and it still leaves many people in need out in the cold. But it’s a start, and for me it’s been a lifesaver — perhaps literally.
    Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the “h” on my Obama bumper sticker, so that it read, “Got nope” instead of “got hope.” I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.

    So this is my public apology. I’m sorry I didn’t do enough of my own research to find out what promises the president has made good on. I’m sorry I didn’t realize that he really has stood up for me and my family, and for so many others like us. I’m getting a new bumper sticker to cover the one that says “Got nope.” It will say “ObamaCares.”http://www.latimes.com/news/opinion/commentary/la-oe-ward-in-praise-of-obamacare-20111206,0,6794828.story

    • Anonymous

      @d1f4d6bdbd30038a190115b7f587a2c9:disqus I am truly sorry that this happened to you and I hope that it does not take that for enough others to take the time to find out what the PPACA will accomplish. As I wrote above, this law with all its flaws was probably the best achievable at this time. When there are “Yellow Dog” Senators like Ben Nelson (D-NB) and Joseph Lieberman (I-CT), both with strong ties to the insurance industry, it is probably a miracle this was passed.

      So often the public does not have, not to mention take, the time to look behind the “sausage making” so that the outrageous claims of politicians can be put in context.

      Thank you for doing your part. Again, may your treatment be successful and you live a long life.

  • Markus

    It’d
    be good to get some facts from Dr. Berwick, but I suspect that he’s just
    another advocate who only cites those on his side. But I’ll listen in and see
    if I’m wrong.

     

    What does Medicare cost?
    I’ve heard the talking points that it’s efficient, but it’s always from those
    who advocate single payer or something similar. Health insurers say that many
    of the costs are outsourced, such as the administrative costs of claims
    processing. They say that fraud is rampant because Medicare doesn’t verify need
    for the treatment very well. They claim it’s grossly inefficient, but then they’ve
    become advocates for the other side.

     

    How much fraud is in the
    system? Is it more or less, proportionally, than is in the private care system?

     

    Are more or fewer
    unnecessary procedures performed using Medicare than the alternatives? What safeguards are there in the Medicare system to prevent this.

     

    The existing system of
    healthcare is a disaster. But before moving more of health care to our
    government, it’d be nice to have more facts.
     

    • Markus

      Argh. Sorry for the formatting. Used a different editor this time. 

    • Terry Tree Tree

      With all the different forms, codes for services, vested interest in confusing the facts, I’ll bet it would be hard to even compare one insurance company, or health plan’s waste, fraud, and abuse, to the next closest insurance company!  Comparing them ALL to Medicare and Medicaid, will take a Super-Computer, I’m sure.  Executives seem to be wrapped up in confusing any efforts to keep them honest!

      • JUST CORY PLEASE!

        I was an insurance intermediary licensed in my state to sell health insurance, and I couldn’t understand it.  The average person has little chance.

    • Anonymous

      @f6f1a53a73a19aa0692e3d58fe20656e:disqus  Medicare has a list of coverages and pays them “on demand” the administration costs are basically the 3% of payments as claimed. That does not mean that fraud is not caught, as demonstrated by the conviction of Florida Governor Rick Scott’s company for fraud, resulting in the biggest fine, over $1 billion, in the system’s history.
      This does not mean that there is a big enough effort to root out fraud. But the system does not encourage a lot of extra services by paying less than what the private system pays, unless the service is only billed but not provided. Then the problem is fraud, not unnecessary treatment. But see the article in the New Yorker about the two towns in Texas where, in one where doctors owned service providers and another where they didn’t, the services prescribed were much higher in the former, but that was across ALL patients, not just Medicare patients.Note that Florida is now having its education and all social safety net programs similarly raided to pay for tax cuts and loopholes for the rich.

  • Steve

    Would OnPoint put Gregg Palast on the show?

    • Steve

      Sorry, Greg Palast

  • AC

    maybe another plague or an infectious air-born disease of some sort will straighten out all the various perspectives…..
    personally, i don’t see how you can have a civil society that turns its back on their ill.

    • http://neilblanchard.blogspot.com/ Neil Blanchard

      I agree.

      We all benefit when everybody is healthy!  Our economy is better when everybody is healthy.

      Affordable healthcare for everyone is enlightened self-interest.

      Neil

    • Steve

      Death Race 2000

  • margbi

    I believe I remember correctly, that when the original Medicare bill was passed in 1965, the AMA came out against this “socialized medicine” bill and they were placated by being able to charge “fee for service” which has brought us to the state we’re in today; each service has a separate charge and a separate cost to the consumer. How many times have you had a procedure and then received bills from numerous services (doctor, lab, radiology, etc.) which you don’t remember receiving and where you don’t know the providers? Unless this can be reformed, the problem will never be solved.

    As for Paul Ryan’s proposal of vouchers for Medicare, he doesn’t understand that the insurance companies don’t WANT to insure older people – they have too many claims which cut into profits.

    • Anonymous

      Good points, which is why we have this huge dysfunctional for profit health care system.

    • TFRX

      Yep. You think you’re going to a doctor’s office, and you’re really stepping into a bazaar.
       

  • Terry Tree Tree

    Please list the Congressmen, and Senators, that have made a REAL effort to expose the Waste, Fraud, and Abuse by their supporters, of ANY government program!
       If they ONLY find it elsewhere, that’s like a Drug Cartel exposing their opposition to arrest, to expand their territory! 

    Put Congress, and the Senate on the same health care plan that the median citizen can afford!  NOT the farce plan by Ryan!

    • Steve

      Requested List:
           1.
           2.
           3.

      • Terry Tree Tree

        Pay me what we are paying ‘professionals’ to NOT solve it?

  • William

    The people running Medicare never seem to get a handle on the massive fraud in the system. 60 Minutes did a show on Medicare several years ago and estimated 60 billion dollars a year is lost to fraud and yet that problem just never seems to be fixed.

    • mary elizabeth.

      That was exactly what Dr.  Berwick was appointed to do-get a handle on Medicare waste.  The Republicans cannot abide any such Obama initiative for the betterment of the nation.
      Dr. Berwick’s departure should be greeted with outrage in the media, in the streets, calls to congress.
      The Repubs are getting away with grevious wrongs in the intent to destroy the Obama Presidency

      • William

        Sure the Republicans are not going to vote for Obama’s programs. Why should they? If you don’t like something you don’t vote for it. The Democrats did everything they could to destroy President Bush (including making a movie of him being shot) so this is nothing new.

        • mary elizabeth.

          Which Democrats made a movie of President Bush being  shot?
          Democrats did “everything” they could to destroy Bush?  Please be specific.

          • William

            Review the history of the Democrats behavior during the Bush years. Remember during the height of the Iraq War Senator Reid famous quotes “This War is lost”, “President Bush is a loser”. 

          • Anonymous

            @0aeb1c67f759dc0e24a92a5eb0bf6a0b:disqus  I suspect you are conflating “W” with Reagan on the shooting; as far as I can remember the only Bush injury in office was his choking on a pretzel.
            But the Democrats let themselves get cowed into voting for Bush’s approach to UN negotiations, when they should have seen (publicly as well as privately) that it was a declaration of war on Iran.

            They voted for Bush’s unnecessary and non-stimulating tax cuts, which just enabled the rich to syphon off more of the GDP growth while workers got little from the growth in their productivity.

            Democrats urged the Bush administration and the FED to enforce rules on mortgages by “shadow banks” but were repulsed by Chairman Greenspan’s comment that fraud did not need to be cracked down on as the markets were “self-correcting.”

            Well, the middle and lower classes always pay the costs of excesses by the rich, which the Democrats seem incapable of changing this time either.

          • Yokohama98

            There was a movie made about Bush getting shot while he was in office. Can you image the uproar if the same thing was made about Obama?
            Democrats ignored the mortage mess just like the Republicans. They all got their payoffs. The majority of the Bush-Obama tax cuts were given to the middle class.

  • Anonymous

    Good OPED on Dr. Berwick. The republicans have struck again.
    http://www.nytimes.com/2011/12/06/opinion/nocera-dr-berwicks-pink-slip.html?_r=1&ref=opinion

  • TFRX

    Can we get through the rest of the hour without one more comment about the “buzzsaw” smelling like “both sides do it”?

    One side is being reasonable about this, and the other side would filibuster ice cubes in Death Valley if Obama came out in favor.

    Now is not the time for the Nice Polite Republican framing.

  • http://neilblanchard.blogspot.com/ Neil Blanchard

    We are pay at least 2X as much for medical car than anywhere else in the world.  They have great coverage for *everybody*.  *Nobody* there goes bankrupt due to medical expenses.

    We need single payer, here in the USA.

    Neil

    • Terry Tree Tree

      FIVE times, with 1/3 un-insured, is the figures I have been hearing!

  • Tina

    What do I want?  I want Single Payer Health Care with the high standards that the Scandinavian countries have.  I do NOT want for-profit companies involved in our health care at all!  

    My second choice is President Obama’s plan for health care even though it does involve major corporate influx.

    I have metastatic cancer.  My brother had a high quadriplegic injury and managed to live with that condition for 15  years because he had health care.  My father’s Alzheimer’s Disease presented itself six months after my brother’s injury.  My mother had Rheumatoid Arthritis, and eventually several small strokes.  I speak from a lot of experience.  

    • Tina

      By the way:
      1)  I want us to stop looking at the poor health insurance/care models worldwide, and look at the successful models!
      2)  I want EVERYONE to be covered!!
      3)  RE:  my family:  we ate intelligently and exercised, did not smoke, and some did not drink at all while other family members drank very little and moderately.

    • Anonymous

      @ac5a65ed7511190e088ed85459acaa7f:disqus As I have said above, the PPACA is flawed; but just going to single payer (“Medicare for all”) is not enough as Dr. Berwick made fairly clear in the program. It will take changing the ways medicine is practiced as well as paid for.

      But Republican approaches (see Ryancare vouchers) will do nothing except reduce the number of people getting care, by pricing them out of the system. Patients will never have the time to learn how to get the best appropriate care in a sea of approaches they understandably lack the knowledge to evaluate.

  • Jane

    Where is Dr. Berwick on true reform of the health care system, getting some control on the rise in prices of care and of pharmaceuticals? Obama’s law does not do this.

    • Anonymous

      Actually he was trying to do this. He was stopped by the political BS that we have in this country.

    • Anonymous

      @fc0d2fa1be7e3ef8eac16751514d0e20:disqus Dr. Berwick explains that “Obama’s law” DOES do this, by building in ways to improve healthcare; by making everyone as healthy as possible will decrease the cost because the waste of redoing, insufficient care will be eliminated. Note also that the cost of healthcare goes beyond what is paid to doctors and hospitals, etc. The costs of disabled (non) workers in both production of GDP and life enjoyment is huge.

  • Kate

    RE: Medicare Waste—The core problem seems to be that we Americans have an unrealistic goal of living forever. Case in point: Medicare pays for a 94 year old man to have a triple bypass—$100K spent on someone who years ago would have be left to peacefully pass away (and by the way had $100K in the bank and could have afforded to pay for it themselves…. I’m not for euthanasia but we have to curb this kind of spending. Your thoughts Dr Berwick?

    • Anonymous

      @a9c48d18c97c7d952e8f509a25c9f6e7:disqus And this issue is what Republicans used to win in 2010 by yelling “Death Panels” and then proposed you be your own “Death Panel” by voucherizing Medicare so the (poor) patient just can’t afford the care even when they have a reasonable high quality life expectancy.

  • Will H

    The major problem with American health care is the fallacy that insurance should cover everything.  We have a system that covers the most expensive medications and treatments at minimal benefit, and yet inexpensive and effective medications are either not available or unaffordable for many.  We should reinvent the system to cover the basics for ALL, and THEN leave the luxury coverage to free market.  We have it upside down, and no wonder we spent so much and get so little in return.

    Will H, Melrose, MA

  • Anonymous

    Why won’t spineless Obama stand up for any of his nominees?  He should have welcomed Elizabeth Warren taking on the Republicans.  Today’s lame self-comparison with Teddy Roosevelt doesn’t motivate supporters.  He speaks loudly and carries no stick. 

    • Yar

      I expect the decision on Elizabeth Warren was made with her.  If she had wanted to go into the buzz saw I feel sure Obama would have supported her.  I have tremendous respect for them both, The congress has avoiding going into recess to prevent Obama from making recess appointments anyway.   

  • Anonymous

    Tom, 

    Can you ask your guest about the potential correlation between two industries that have staggeringly rising costs and are heavily controlled by the government, Education and Healthcare.

      If you look at industries that have less government intervention, the increase in cost over the last 30 years has been 1/4 of that in these industries and the products have improved much more than Education and Healthcare.

    • Anonymous

      You mean like Germany, France or Canada.
      We spend more than any of these nations and cover everyone. Go figure.

      • Anonymous

        They have long waiting lines, doctor shortages, limited coverage, sometimes rationed coverage.

        • JUST CORY PLEASE!

          I’d rather wait than have none at all

        • Terry Tree Tree

          WE have one of the highest ratios of physicians to citizen ratios!

          • Anonymous

            @Brandstad:disqus Actually, unless you can afford a “consi… practice” [I can't remember the term] wait times for a yearly exam run three months or more, moving an appointment with an oncologist to a different time is near impossible with the present system. It is no worse and oftentimes BETTER (shorter or more flexible) in other systems.

        • Anonymous

          @Brandstad:disqus  I invite you and all others to view Cindy’s comment below. It is only one case, but it really does encompass much more, all but the “private” plans of the rich.

      • Anonymous

        How many people from Germany, France or Canada come to the US for treatment?  How many Americans go to Germany, France or Canada for treatment?

        • Anonymous

          Not many. What’s the point, that rich people can afford the expensive fee based health care we have in this country. Oh please.

        • JUST CORY PLEASE!

          How many of them are rich?

        • Paul

          I don’t know how many come here. Its my impression that it is very few. From third world countries the situation is different.

          Actually quite a lot of people from the US go abroad for treatment. I have heard its cheaper to fly to Germany for extensive dental care than it is to get it done here, including the travel costs.

          And there is quite a lot of travel to India for medical care too.

          And for plastic surgery Brazil is the place to go.

          Brandstat – I see you are waving your american flag. Have you *been* to any of these other countries with “socialist medicine”? Have you spoken to people from those countries about it?

          • Terry Tree Tree

            You don’t expect him to speak from actual experience, do you?  The flag is enough for some!

        • Anonymous

          Google “medical tourism” and you see that a lot of our citizens go elsewhere for treatment too.

        • Anonymous

          @Brandstad:disqus The vice president for human resources at a company was in Paris and fell on a tour of an ancient tower, requiring a helicopter to extricate her and take her to a hospital. There, on learning of the complicated procedure to reset the broken bones, etc., she insisted on flying back to the states on a “stretcher” for the procedures. When discussing her case with her prestigious New York doctor, she was asked why she hadn’t had the operation performed in Paris, since her doctor would have been one of the top five in the world for that operation.
          And it would have been cheaper!

          A couple years ago, Charlie Rose had a heart problem that required state-of-the-art care and he got it in France. This is documented on his show in programs broadcast in the summer of 2010, I believe.

          Brandstad, your argument is false at/to the core!

    • TFRX

      Yes, let’s go there. Nothing that the profit motive won’t fix.

      Let’s talk about health care insurance companies, whose job is to keep from insuring sick people. Let’s talk about charter schools, who get to cherry-pick the students they want.

  • Rex

    Is the British Healthcare system bad?  I don’t know.  What is the senator’s argument?

    • Anonymous

      @055e21247836f2d3a6e8fd058ec19771:disqus  During the Thatcher prime ministership, funding for the National Health System (NHS) was dramatically cut supposedly to force users to get better care. It DID NOT WORK, with the end result being poorer care, particularly for the poor. While Blair was prime minister funding was restored and consultants such as Dr. Berwick were hired to help bring the NHS into the 20th/21st centuries form of equitable healthcare.

      Today’s Republican approach is more similar than not; it violates every moral precept that all religions, and maybe Christianity more than others, espouses.

  • Chaz

    Health care for profit should be stopped. The care of human lives should never be a money making venture!!!

    • JustSayin

      Glumbert?

    • JUST CORY PLEASE!

      You’d like to think humanity has reached that point, wouldn’t you?

  • Anonymous

    Health Insurance is a model of negotiating ‘muscle’ lowering costs by their “ownership” of a proportion of the market, at the expense of the rest. Nothing more than a middle-man taking their cut. They add no value. Only in the USA!

    I’ve heard that Maryland had mandated a code/procedure based fee for health professionals. Anyone walking in the door pays the same price. 

    That is a good beginning.

  • Cindy

    Living in the Boston area, I frequently have encountered a 4 month wait to see a specialist.  Waiting for medical appointments already exists. I also have worked for companies which offer only 1 health plan.  I do not understand people who say they don’t want Canadian/European waits or lack of choice. 

    • JUST CORY PLEASE!

      And would be rather wait, or have no health care at all.  I’ll wait, thank you kindly!

  • Terry Tree Tree

    If the U.S. pays five (5) times, for Health Care what the next developed country pays for Universal Health Care, with 1/3 of our people un-insured,  that means we’re paying almost EIGHT times as much!

    • JUST CORY PLEASE!

      You mustn’t have heard that we have the “greatest health care system in the world”.  That’s why it costs 5 times as much.  If we nationalized health care, where would wealthy Canadians go to circumvent their own nationalized health care system?  How can you be so cruel?

  • Kathy

    The guest just stated that in Britain you never wake up wondering if you’re going to have or lose your health insurance. That’s true. But then he went on and said “and now we have that.” 

    Um no. We don’t. We have a very minor revision to the private health insurance system. People will continue to go bankrupt from medical costs, if you lose your job you’ll continue to lose your health care, and we will continue to have people who simply can’t afford to go to the doctor.

    We need an NHS.

    • Anonymous

      @ac552193b38a1e4ce5d898a35aa4174e:disqus I can’t give the quote your citation or the other quote where he acknowledges that the PPACA covers most Americans though not all. But it is a big step up, not least from the perspective of the previous insurance company approach of denying coverage for “preexisting conditions.” That later change is the reason that there is a mandatory requirement that everyone buy a policy.

  • ClearThinking

    Please tell us about all the pharmaceutical therapy and medical device innovation that goes on outside the US.

    • Anonymous

      Actually, a lot of innovation in treatment comes from foreign countries, who probably operate in less restrictive environments than ours, according to my doctor friends.  And most from ours is at government expense or subsidy.

  • JustSayin

    The Senate does NOT speak “American public opinion”. They speak for who pays them.

    • Anonymous

      @eb6e941afefc55d914e933031fc4b98a:disqus  In campaign contributions (where left-over funds are available for private use). But even worse is the 50% to 70% of a legislators’ time spent soliciting those funds instead of reading bills and background information so as to determine what will be effective for their constituents.

      It is much easier to learn the Frank Luntz motto of the day.

  • TFRX

    Not that GOP “debate” fantasy again!

    For the last time: When a 30-year-old has a good job, IT HAS HEALTH INSURANCE!

    Only in the self-reinforcing black hole of knowledge that is a Republican ‘debate’ does someone have a good job without health insurance. You and I know many people who kept in a crummy job because of the semi-crappy health insurance that came with it.

    Why can’t On Point stop replaying this right-wing wet dream of a gotcha question without explaining this basic point?

    • Anonymous

      @5d54d6ea3db98a8fd159aba853061462:disqus Unfortunately, this is not the only area where the mass media plays stenographer and provides a “balancing” statement from the “other side.”

      The only good here is that NPR does it a little less often than the other media. [Fox News is NOT information media; just entertainment media for the knowledgable on a good day; see the Daily Show.]

  • Charlie

    The quality of the health care I received dropped and cost increased dramatically when my local clinic was bought by a chain.  Before hand at my annual checkup they would do everything they could in that visit, remove ear wax , explore a new ache whatever.  After the corporate buy out of the clinic anything beyond the basic exam would be scheduled for another visit or a referral.  What would have been done in one visit turned into several visits, this was new clinic policy because it maximized profits.  My doctor was obviously generating more income for the clinic, but neither he or I felt he was providing as high quality health care.  Later I found that he  (my doctor) took a pay cut with the new owners. 

  • Be_Visionary

    I’m a big fan of Don Berwick. Why not get you, Cleveland Clinic, Gates Foundation, Buffett, Apple, and Google, etc. and pilot a state and show how you can all make healthcare ‘correct’. Money, vision, technology, communication, etc.. would be revolutionary! No joking. Think about it.

  • Amander5492

    I am a pharmacy technition at a retail pharmacy in Massachusetts. I see people who abuse medication get it from MassHealth for little or no money. I am a big supported of Medicaid and Medicare and think it is great for people who need it. But I would like to know if there are any safety measures in place to prevent the abuse of drugs in the Medicaid and Medicare systems.

    • Anonymous

      You mean technician, the abuse you are talking about is more about the system. By the way the abuse that big pharma does to the citizens of this nation far out ways what you are mentioning. 

    • Anonymous

      Isn’t there a system for you to report abuses?  Don’t you have an ethical obligation to act, either to prevent known abuse or report it?

  • Mike

    OMG!  This guy makes the most sense out of any damn Republican idiot I have ever heard speak on this topic yet.
     
    Dr. Donald Berwick for President!!!!!!

  • Terry Tree Tree

    I hope that some organization with money will pay for Dr.Berwick to tell the nation his views!   ESPECIALLY the ‘conservative’ ‘Chrisitan’ areas, that want to let people die!  That’s ‘conservative’?  That’s ‘Christian’? 
       The lead opponents to a Universal Health-Care plan, HAVE health-care, they’re RICH!  OR they have the health-care plan of Congress, and the Senate!

    • Anonymous

      @fa0bc679d4cba4c097672d7e5c15d631:disqus  Remember, most legislators, particularly Senators, are millionaires or more. But they have NO incentive to reduce their benefits.

  • Scott B, Jamestown NY

    The Republicans keep hammering the issue that the government wants to ration your care, mostly by coming between you and your doctor.  Until Democrats hammer back harder, and make the point that the insurance companies are not employing kindly old doctors to make sure you get the care you need – that in fact it’s the opposite (hence all the denial of coverage, and dropped coverage, stories we all know, many times personally), they will continue to lose that argument. 

    Dems need to pile on the cause and show how paying your doctor a small fee is not a “death panel”. Make it $50 and pay the docs ASAP, it doesn’t take that long to check off a few items. Put some ads in magazines, newspapers, online forms, etc., that they can take to their doctors, share with their families, and get the conversation, and the savings going.

    When asked about the items in the Health Care Reform Act, Americans like it. They just worry how the money is going to be spent, an rightly so. So show them.

    One thing I would suggest – Get rid of COBRA for the unemployed and let them buy into Medicaid directly at some small fraction of their unemployment benefits. COBRA, even at the recently “reformed” rates is still insanely high.  Move the decimal point to the left a digit or two. Then we’d have people paying into the system, not people that forgo insurance so they can eat and stay in their homes, and then costing far more to society and taxpayers when some medical emergency hits them. 
    Then when (not just “if”) they find a job, let them choose to stay in the Medicare system and pay a reasonable premium, or opt out if they get a better offer from their employer. 

  • Pam Chamallas

    I would like to ask Dr. Berwick why the Insurance system, that is all the insurance companies, has never been streamlined as a start at savings? Every insurer has a different billing methodology and physicians and hospitals spend hundreds of millions yearly just to get their bills paid

    • Anonymous

      Do you know that the AMA owns the rights to the coding/billing system?

    • Anonymous

      @c1793d15fa220ce9f206ee73d5536caa:disqus It all comes down to the “free market” where everyone is allowed to test his/her approach to see if it can out-perform the others.

      We don’t have digital AM radio (like they do in Europe) because no one could pick a “winning” system and we almost had an analog HDTV system that would not be nearly as good as what, by luck of timing, actually got selected.

      The choice of NTSC for early (black and white) TV set a system that deeply restricted the addition of color (for backward compatibility reasons) and that was about to be continued for high definition.

      Consider the wars between video tape formats and the potential war over HD formats (thankfully BlueRay won early).

      It is important to have competitive systems at the beginning as long as their relevant advantages are adequately explored; but then a “universal” system needs to be selected so different providers have an equal cost basis.

  • Amandatakemoto

    I have no desire to participate in a “for profit” health care system.  I fully support a single payer system funded through taxation.  

  • Mike

    So typical of Washington to get rid of the best people for a job.  No wonder this country is so screwed up.

    • Anonymous

      @915b94a5329a6beff38f4be637606768:disqus  And this might not be the worst example, though it is a strong contender; another occurred when David Diamond, a Nobel Laureate in economics was denied appointment to the Federal Reserve Board. It was particularly indicative of Republican motivations, since Dr. Diamond (of MIT) specialized in employment issues and one of the legal objectives for the Federal Reserve is to keep unemployment to a minimum consistent with low inflation. He could have explained the costs to ALL of us of high unemployment to those members who only think of potential inflation.

      The contribution Dr. Berwick could have made by being able to have a longer tenure in this transitioning time is incalculable but certainly large and a great loss for the country and those people who will be patients in the healthcare system over the next 20 or more years.

  • Markus

    Nothing on the
    weaknesses of the Affordable Care Act. Bit of a cheerleader, as I expected he’d
    be. This legislation was thrown together with all kinds of promises to
    different states and, from what I heard, very little elements that would reduce
    costs. Nothing to prevent unnecessary tests, for example. Also, the studies
    generally show that preventative care costs more than if you don’t have it.
    This may or may not be true, however, it’s fair to say this is debatable, which
    he failed to mention.

     

    So, he showed some
    honesty on rationing and the high costs of Medicare. And the republican audio
    made the senator sound like a jerk.  But the
    doctor seems like just another advocate who I can’t trust.

    • Anonymous

       Well that’s your opinion. He’s making sense and by the way he did make some really good cuts and tried to rein in costs on Medicare and Medicaid. The proof is in the pudding as they say. I say Medicare for all.

      • Markus

        He’s making a lot of sense in identifying the problems. And if he made good cuts, good for him. My problem is he’s no different from any other advocate who only gives one side of the issue. He’s an advocate for Affordable Care Act, which was thrown together by buying off various legislators and will not solve the problems he’s identified (IMO). So, he may be right and I’d like to see single payer happen, but since he’s become a cheerleader, I can’t trust him.

        • Terry Tree Tree

          Unfortunately, we have people in government, that are bought by special interests, to the point that they will do what is HARMFUL to the nation, for the special interests!  ‘Compromise’, to those people, is GIVE IN!

        • Anonymous

          @f6f1a53a73a19aa0692e3d58fe20656e:disqus  Do you mean that if I say I am glad that the PPACA passed, while admitting some reservations, because I think the act will improve healthcare and reduce costs, I cannot be trusted?

          Would I be more trustworthy if I had decided that the lack of a public option meant the law was a failure even if it brings the cost of healthcare below what it otherwise would be?

    • Terry Tree Tree

      Republican changes to the Affordable Health-Care plan, got those expensive changes!

  • Anonymous

    We should add dentistry to this issue. All health care starts with this.

  • Kathy

    The guest just stated that costs will come down with the affordable care act. If that’s true, why has an identical plan in Massachusetts not led to any savings?

    • Terry Tree Tree

      In comparision to a near-by, comparable state with just the Insurance Industry’s choice of plans?

    • Anonymous

      @ac552193b38a1e4ce5d898a35aa4174e:disqus  That is one of the differences between Massachusetts and the PPACA. The Massachusetts law concentrated on getting coverage as near universal as possible and there are now additions which are crafted on reducing costs based on the early results from the MA healthcare law.

      Some of those approaches and additional ones are in the PPACA, and will bring reductions in costs nationwide as their effects kick in. But because there are no strongly proven models for just what the effects will be, the Congressional Budget Office will not evaluate them.

  • JP

    So long as Republicans have any say, Health Care costs will continue to erode our country’s prosperity.

    So long as the public allows them, Republican’s will continue to lie to the gullible regarding the truths about Health Care, and our situation will continue to worsen.

    Stop listening to Republican lies and let The Affordable Healthcare Act finally begin to take hold and improve our Healthcare outcomes and costs!

    Healthcare has already begun to bankrupt our country and The Affordable Healthcare Act hasn’t even begun to kick in, YET REPUBLICANS WOULD LIKE YOU TO BELIEVE THAT SOMETHING WHICH HASN’T EVEN BEGUN IS SOMEHOW RESPONSIBLE FOR OUR RIDCULOUS HEALTHCARE COSTS.

    STOP LISTENING TO REPUBLICAN LIES!!!

    If it weren’t for Republicans, we’d have what we really need, which is a single payer system! Since Republicans made that a no-starter, The Afordable Healthcare Act is our best hope to improve health outcomes and costs!

  • http://www.facebook.com/walter.weizenauer Walter Weizenauer

    Republicans and Libertarians cheer when it comes to cutting someone else’s benefits and telling someone else to go home and die.   The tune changes when the one being cut might be them.

    • TFRX

      But it’s never them!

      Their fantasy is that each of them is Howard Roark and Dagny Taggart, the same way that each of them laugh at the nerds because they so should have been homecoming king and head cheerleader.

    • Terry Tree Tree

      HYPOCRICY?  From the party of ‘conservative’ ‘Christians’?

  • jl

    Yes, Mr. Berwick- please answer question as to why our health care expenses and out-of-pocket are rising!  For the first time, I am forgoing advised tests even tho’ I have ins.

    Thank you.p.s. Massachusetts resident

  • Leigh Winston

    Agree with last caller, was hoping for single-payer plan…oh, well.

    Would like to say that as a Tricare beneficiary, I have never been disappointed in my care, and as a doctor, have not had complaints from anyone with Medicare, Medicaid or Tricare.  Government IS capable of administering care, and can do it FAR more efficiently than private insurers.

  • BHA in Vermont

    Contrary to the Republicans’ claim that Americans do not want universal “England” style health care, it is EXACTLY what we want and need.

    But I guess some people think that only the rich should be educated and have health care.  Everyone else should have planned better for unforeseeable illness and should have chosen their ancestors better so they would have inherited money.

    We NEED Universal health care with at least a basic level with ‘supplemental’ insurance available for those who want and can afford it. Yep, a MEDICARE for all plan.
    - Single payer – all medical care providers deal with only one company. No need to chase down “does this patient have a co-pay? Does THEIR insurance cover this visit?” etc 
    - No more “My company bargained a better deal with big Pharma and hospitals than yours” deals. For example: A drug should cost a $1.00 for EVERYONE, not $0.25 for one and $4.00 for another based on their insurance.

    At the moment, insurance carriers treat their customers as a PITA with coverage denied whenever possible. For example, my daughter had some visits to a PT approved but in a specified date range. The PT had to cancel one appointment and the ‘replacement appointment’ then fell outside the ‘window’. The insurance wouldn’t cover it. I guess WE should have planned the PT’s life better so the last appointment in the ‘window’ wouldn’t have been cancelled. Clearly OUR FAULT for not being RESPONSIBLE. Instead, the PT didn’t charge for the visit because she knew the insurance WOULDN’T PAY. We appreciate it but it is not fair to the PT to eat it just because of insurance company bureaucracy.

    • Terry Tree Tree

      Your experience with the ‘conservative’ ‘Christian’ concept of ‘caring’?

  • Anonymous

    Tom, Can your guest list government agencies that have greater efficiency than the private sector?  Why does he think making healthcare a government decision will make it better?  Shouldn’t medical decisions be made by the doctor and the patient?

    • JUST CORY PLEASE!

      They aren’t now.

    • TFRX

      You’re forgetting the decisions made by insurance companies. But don’t let that stop you from JAQing it.

      Shouldn’t medical decisions be made by a doctor and the patient?

      I don’t know. How about we ask a Mississippi teen who has a pregnancy scare?

    • Terry Tree Tree

      An Insurance executive NOW makes the decision about your health!
          Under the Republican ideal, they will have MORE say about it!

      • Anonymous

        Are you a republican party member?

        Are you high ranking in the group?

        What are your qualifications for speaking for them?

        • Terry Tree Tree

          YOU haven’t heard the promises, the ‘NO’ government until Obama is out of office attitude, and the support for the WORST aspects of our Health-Care system?

    • Anonymous

      EPA, FDA, CPA, for a few.  That is, unless you prefer the “efficiency” of lead in your kids toys, your rivers so polluted they can catch fire, and being a human guinea pig every time you take your medication.   

  • Bruce

    More evidence of the Tea Party-dominated GOP creating dysfunction in government, and then decrying such dysfunction.

    Another nomination blocked for no other reason than perversely partisan posturing.  Other examples of egregious manipulation of advice and consent and filibuster rules include Elizabeth Warren (Consumer Protection Agency) and Peter Diamond (Federal Reserve Board of Governors). 

    Once again, the GOP as defenders of the status quo and guarantors of policy failure and government gridlock. 

    And in health care as in financial regulation, the GOP hijacked by laissez-faire extremists with a Randian vision of our future like  Paul Ryan’s Path to America’s Ruin, which dismantles among other things Medicare and balances the budget on the backs of the poor, elderly and disabled.

    • Terry Tree Tree

      They are bent on the destruction of the U.S.!!  For the benefit of the GREEDY rich!

  • Jsendry

    I’m in complete agreement with Dr. Berwick that Medicare as it stand is untenable. I am a Medicare recipient. I need an at-home nebulizer. Through Medicare, I was able to “rent” the equipment for 13 months and then it is mine. The rental fee presented to Medicare is approximately $150.00 a month, but the provider agrees to accept Medicare’s $15.00 or so a month. I had a co-pay of about $60.00.  Sounds like a good deal, right? Wow, that thing is worth $1950 or so. Medicare ends up paying a total of $195 and I pay around $60 and then I get to keep the equipment! Except that I discovered that I could have bought the thing outright from Amazon for around $30.00. When I complained to Medicare, to the provider and to my doctor, the response is the same: That’s the contract that the provider has with Medicare. I even wrote to my Senator and got no response. I’m tired of the old “wink and nod” of “That’s how it is and you can’t do anything about it. (You’re a fool to think otherwise.)” Yet that attitude pervades the healthcare industry. Witness the Senate’s treatment of Dr. Berwick.

    • Terry Tree Tree

      Another Good Example of the problems!

  • JMC

    any discussion on wellness programs that reward patients for staying healthy? i see many of these ideas popping up and wonder if insurance companies would lower rates based upon wellness initiatives.

    • Terry Tree Tree

      Insurance companies make LITTLE money on well people!  Therefore, they are against it!

      • Terry Tree Tree

        I WAS bein facetious!!

    • TFRX

      Tangent: Is your insurance company is mailing you flyers about wellness? Is it full of trite stuff you likely already know about common lifestyle choices, exercise, diet, and such?

      Well, that counts for them as “money spent on prevention” the same as if they paid for a preventative drug for a chronic asthmatic/diabetic/etc, or yearly physicals. They actually get credit for having contributed to your healthcare with that junkmail!

      That’s a sweet, sweet racket.

  • sailon_52

    Republicans talk about ‘rationed care’. That’s what I have had with health insurance all along. I pay my own health insurance and am now paying $7,000 a yr., plus a $2,000 deductible, plus co-pays. I have had to change Dr.’s every few yrs. because they don’t take my insurance plan. I pay all of this and can’t even use any Dr. or hospital in Boston!! So much for access to our “best health care in the world”. Republicans are in denial and they have no solutions to help Americans get health care.

    • Terry Tree Tree

      Thanks for the example of the HYPOCRICY!

    • William

      So if we had “Single Payer” covering 250 million or so Americans and 20 million illegals what do you think you should pay in taxes to support that? And of course, there are 47 percent of working Americans that don’t pay any Federal Income tax so you might be paying the same or more for Single Payer.

      • JMC

        so lets just say we make it a montly premium at a level 100 million can likely afford, $500 a month for full coverage.
        500X12monthsX100,000,000 participants old, young, healthy, unhealthy=600,000,000,000 annually.

        Seems sustainable to me and affordable, and only requiring a portion of the poulation to support, maybe we make another 100,000,000 in lower income brackets to pay half of that premium or $250 a moht.

        That would add $300,000,000,000 to the pemiums or a total of $900,000,000,000 billion a year. and it is afforadable.

        • William

          The feds spend about 900 billion on healthcare this year. How much does the private sector spend? How much is not paid for and written off? So 900 billion won’t cover the costs.

          I would think a last resort medical plan offered by the feds would work. You can’t get medical insurance you go to the feds. The Feds offer you a basic medical plan and means test your payments. You pick what you want to pay for and no mandates. A younger, healthy person might not want much more than a basic plan, whereas, an older person wants more coverage. 10-15 million people paying at least 4-10 thousand dollars a year does make a dent in the cost to the taxpayers to cover them.

      • Anonymous

        Actuaries would tell you “a lot less”.  A group insurance policy with the largest possible group, that is , EVERYBODY, in it, is always going to be the least expensive.

        • William

          Then why does Medicare cost so much?

  • tired of hate

    Republicans are not willing to do anything that would make Obama look successful.  They have been blocking appointments for his entire term.  They remind me of the Clinton era opposition, only his was done by Newt’s congress and they spent so much money on one investigation after the other.  Think of all we could do with the money wasted.  I worked at a university hospital for 18 years as an RN.  I watched as the insurance companies took over control of our health care system, wrenching decisions away from doctors and nurses, and other care givers.  They decided that if you had your gallbladder out you would only get to stay in the hospital a certain number of days.  Another case of trying to fit all the people into a narrow possible outcome.  This was back in the late 1980′s.  How much money to insurance companies spend on advertisements, including companies like Humana, who are trying to get Medicare recipients to choose their services, by paying millions.  Wasted money, again.

    • Terry Tree Tree

      MORE revealing info!  Thanks!

  • Terry Tree Tree

    One National study, six years or more ago, says 56% of Malpractice, is committed by less than 6% of physicians, but the AMA will NOT revoke their license to practice medicine!
        ONE-HALF of Malpractice could be rid of, with this simple action, but AMA WHINES about higher Malpractice Insurance costs!
       How much actual health-care-cost would be eliminated, with this simple action?

  • NMWMDMPH

    A prophet is not without honor except in his own country. 
    I thank Dr B for his intellect, honesty, commitment. Physicians know there are compliant patients (Sweden) and arrogant resistant patients (US) death will come to them both but the path to that end will be very different. 

    Self-reliance in health care is admirable, but ignorant arrogance hurts not just the individual but his family and community. A healthy US population is a competitive advantage  globally. Me versus Us its the same story over and over.

    Stubborn political “opinions” about the President Health Reform will not help our children. Making Health a political football wastes money and time and is unpatriotic. It sacrifices the health of all to ideological doubletalk or pandering to our natural fear of change.As a physician, I am sorry we have squandered the trust of the public so that they no longer believe that Dr Berwick is acting in their own best interest. 

    • Terry Tree Tree

      Thank you doctor, for some more insights!

  • Toni Pricd

    We haven’t had a sustained, high profile public discussion of the role personal responsibility has in containing costs: controlling obesity, etc. When can this discussion take place?

    • http://neilblanchard.blogspot.com/ Neil Blanchard

      You’re right Toni, we need to have that discussion and several others related to healthcare.  I think however, that most of the obesity problem in this country stems from a broken food system.  If you look at people from before we got factory farms and lots of processed food, you will see a lot of slim people.

      Neil

    • Anonymous

      The first lady’s attempt to  focus on this gets her denigrated by the ditto heads and booed by NASCAR fans for trying to tell them what to eat.

  • Charlie

    Will it be possible for the current health care reform to go forward if the insurance mandate is overturned by the Supreme Court?

  • JUST CORY PLEASE!

    Fine.  We’ll never get national health care.  Could we at least have not for profit models?  Could health care be treated as a utility that EVERYONE needs?

  • Carol

    What does Dr. Berwick think of Vermont’s single-payer health care plan? Is this a feasible route for other states to take?

  • Rjabski

    I’m considerably pesimistic about the outlook for affordable healthcare. In my opinion, about 30% of the American public are egocentric leaches that cause other American to pay for their health care. These persons go at risk by not buying health insurance, but when an emergency or chronic illness strike, they go to a hospital to get service at no or unreasonable low costs. The cost of this negligence is passed on to the rest of us by increasing our taxes and increaing the overall cost of healthcare for all Americans.

    The irresponsible Americans ( the 30% ) are putting the U.S. economy, jobs, and the healthcare system in a position to fail.

    Many Americans have been misinformed about the above situation and fail to see how it is damaging our Nation.

  • Kathy

    I’m so glad the caller rung up to declare their love for the liberty to die without health care. God Bless America!

    • Terry Tree Tree

      What are those of us, that served our country, that work, and take care of our families, that want  a simple, less-expensive, sensible Health-care plan, that is LESS expensive?

      • Kathy

        I think we’re socialists and therefore un-American. These are bizarre times.

        • Terry Tree Tree

          Yes, ‘W’ called me unpatriotic, because I saw through his ruse for the Iraq invasion!  Even though I showed up for duty, NOT AWOL drunk, and served with honor, until time was up, DIDN’T Desert, when given requested duty transfer!

  • Anonymous

    The caller John can go off and do what he wants.
    However he is not free. His insurance company is already telling him what he can and cannot get in terms of care.
    He is blinded by ideology.

    I’m not going to trust the market deal with health care, period.

    • Yar

      I think he said he was self insured, I think he really means he is uninsured.  

      • Will H

        And self insured means free care, as no one except those in the 1% can afford to be self insured.  You can feel self righteous about being self insured until a major illness.

        • TFRX

          I had a policy like that once: “We’re here right up until the moment you need coverage.”

      • Anonymous

        Why is it that a clerk at the clothing store who lets someone walk out with items they know that person will not pay for considered a thief, but an ER physician who provides hospital services to someone they know will never pay for it not?

        Doctors want health care to be a right when they provide it but a commodity when they want to be paid for providing it.  Can’t have it both ways.

  • Mike

    Our failure in health care is reflective of our failure in education.  We spend the most on both of these industries, more than any country in the world and both are sub par.  When are we going to stop listening to the special interests and start rebuilding this country and restoring its greatness.  

  • Charles A. Bowsher

    We will never get to “affordable” Health Care until people like Mr Berwick and President Obama learn to speak clearly and directly about this issue.  Medicare delivers Health Care to a most difficult population more cheaply (adminstrative expenses) than any other system.  Why can’t you speak to the fact that sales commisions, salaries and bonuses for Insurance Sales people do not add one iota to anyones health, yet the money we spend on that is a “health care expense”.  Administrative expenses are also another hole that our health care dollars fall into.  Single payer is the only way to have affordable care.  Base it on a “Wellness Care Model”.  Wake up America. 

  • Terry Tree Tree

    To the caller proclaiming “Free-Market”, IS it a ‘Free Market’?  Or does the Medical field have it SO confusing, that YOU cannot actually compare medical plans, costs, results, physicians, hospitals, etc…?

    • Kathy

      Not to mention the free market relies on turning down things that are unaffordable. When HDTVs were $2500+ I didn’t buy one. We lived with a normal TV. The prices came down and now we have one. But with medicine, the consequences are a bit more steep than doing without HDTV. You essentially need a large cadre of people willing to die for lack of treatment in order to bring prices down.

    • Bruce

      Right, the classical laws of supply and demand that libertarians want to apply to all sectors, do not function well here. 

      1) Accident and illness are largely unpredictable and purchases of health care cannot be planned as with other goods and services.

      2) Third-party payment whether private or public distorts consumer decisions based on net vs. actual gross cost of health care purchases.

      3) Medical information is asymmetrical, that is, too expensive and beyond the reach of most consumers.  Entry into the medical profession is limited; medical education extremely expensive. There are obvious monopolistic and oligopolistic forces in the medical sector that impeded price competition, limit supply/access and add to runaway costs.   

      4) Private insurance incentive is to shrink the risk pool to include only the young and healthy, and to dump elderly and sick customers onto public or charitable programs.  Public health model is the opposite, that is, to increase the risk pool to include everyone, thus providing a more humane system as well as more efficiency (cost are borne by everyone).

      5) The prevailing view in our society that health care is a human right leads to the provision of life-saving emergency care at all hospitals, and the free-rider problem that Ron Paul addressed in such a stunningly  amoral manner.  The “individual mandate” does provide a morally acceptable solution to the inefficiency and irresponsibility of the cost shifting that occurs when free-riders seek life saving treatment. 

  • anon

    Granted the centrality of quality improvement, whose definitions of quality are to be used (Institute of Medicine vs. “Pharma” vs. voter referenda vs. other)?  And by what mechanism(s) should quality be measured??

    MD in Nebraska

  • Diane

    The costs of healthcare in America are bankrupting the country. Healthcare is not a commodity; it is something we all should have equal access to when we need it. As long as health insurance companies and health care providers are publicly-traded entities, their first priority is to their shareholders, not patients. If we are not to dismantle health care insurance and hospital groups, then they should become nonprofits. That alone would save billions and billions every year. In addition, pharmaceutical companies and medical device manufacturers ought to have better oversight, simply because they deal in products in which the public trust is placed.

  • Charles

    With obesity and diabetes so high in this country I question how we can possibly afford to provide health care to such an unhealthy public. I take care of myself, exercise, don’t smoke  and eat right am I supposed to pay for all the people’s health problems who don’t bother to take care of themselves. I feel that congress should start doing their job and stop pandering to lobbyist  they can do things like ban High Fructose Corn Syrup as a food additive this would save the nation trillions of $ instead of letting the corn growers association use tax payers dollars to lie to the American people.  We need to improve the health of the nation first so that health cost come down to something manageable.

    Charles

    Middlebury, VT

    • Terry Tree Tree

      Some Good Points!  
          Expanded, it means that the current Health (?) care Industry, PROFITS, from the high-frutcose, health-reducing diets pushed by high advertizing, probably-connected, processed-food industry, that PROFITS from people being less-able to prepare healthy foods, and get RESULTS-ORIENTED Health-care?

  • Leigh Winston

    Good question.  I do not know any statistics on this, but I know numerous Americans who went elsewhere for care (France, Canada, Argentina, and Angelina Jolie went to Namibia, Africa to deliver one of her babies!)

  • JMC

    so lets hasve an open “free market” pool of citizens wanting to create their own health care supported by the fed such as a public option and allow people to choose. Those that do not can continue with their private plan while the rest of us support the public option, that is freedom. Those that choose to opt out will not have to pay into the program, they may continue to pay their 1k premium to the private insurance companies with limited benefits.

  • Jake Stanish

    The caller John from Alabama made some distinctions with regard to liberty that are fundamentally flawed. To require healthcare, or to subsidize those who can’t afford it, is neither big government nor compassion — while it is often sold on this basis. Such measures are simply a means to liberty — for it is hard to be a free and productive citizen if you are dead. Universal healthcare garners liberty, it does not garnish it.

    • TFRX

      Can’t agree more. Someone who calls up and is self-insured who worries about “liberty” but doesn’t know the meaning of the words “risk pool” is a sucker.

      • Yar

        How much would a self-insured individual have to post as a bond to back their potential healthcare cost?  1 million, 4 million or more?  I doubt John is really self insured, I expect he is more likely to be judgment proof.  Can’t get blood out of a turnip, so to speak.

        • TFRX

          That’s an interesting idea: Caller John is another one of those people “rich enough to be a Libertarian” passing himself off as regular folks.

          In high school I first rode a motorcycle for two years because auto insurance was that expensive (i.e. more than a car) given my age. The law at the time was that one needed auto insurance up to $XXX or a bond of $ZZZ dollars.

          I harbored a fantasy of having enough money to not have to buy the insurance, and my dad explained that if I were to save up that much money, buying insurance was the far better thing to do: In case of an accident I would have to pay for whatever happened out of that $ZZZ dollars.

          Someone needs to explain that to him.

      • Frank

        You can’t cheat an honest man.  f

    • Anonymous

      I could not have said it better. John has been sold a bill of goods and this is part of the problem. How do we reach folks like John?

      • Anonymous

        Here’s how:  When they show up seeking care for a life-threatening injury or disease, without insurance or the immediate means to pay for it, you deny them care and let them die.  Other people can then decide if they want that “liberty” or not.

    • Gregg

      That sounds good but the government has no money. How is it liberty to take money from one citizen and give it to another? 

      • Frank

        “That’s what freedom is, taking your own risk.  Let him die.” – If you don’t believe we’re all in it together, then put on your loin cloth, grab a knife, and go live in the jungle.  You’ll find that your life will become poor, mean, nasty, brutish and short.  f

  • guest

    A physician who was part of a coordinated care effort spoke  a while ago on npr and talked concretely about how taking care of people with chronic conditions and care decreases cost in the system. I think others need to hear about how others in the system cost each of us. 

  • Scott B, Jamestown NY

    Insurance companies are killing medical care in the US. They routinely deny insurance, or necessary medical needs, so it becomes more expensive for consumers to find insurance, if they can find it all. They raise rates so more people forgo insurance because they can’t afford health insurance and afford to meet life’s basic necessities, like food and shelter.

    All this culminates in the people without insurance costing more when they need health care because they have no primary medical person to go to to nip it in the bud at the medical care-givers’s office, and they’re in worse shape because they wait, hoping to get better on their own with OTC meds, and end up in ERs and going bankrupt.

    *****
    There’s this myth that we have the best health care system in he world and it’s been repeatedly proven to be untrue by any measuring body’s study you can point at. The one exception is that if you have trauma, or need a transplant, yes, the US is probably the place you want to be. But by any other measure the US lags far behind the rest of the world.

  • Leigh Winston

    As a doctor, I can confirm this kind of RIDICULOUS pricing for durable medical equipment.  Ridiculous!

    • JMC

      agreed, my wife works in the medical field and says the same thing, the medical device and supply industry margins are disgusting, i would predict an average ROI of 200 to 1.

      • PharmaRep

        Show me the company that has those margins.

        • http://www.facebook.com/people/John-McMillin/1276415119 John McMillin

          well we will do a quick example of a top of the line toilet seat, $178.00. I would guess the cost to bring it to market is about $11 from ny own product analysis. you are a complete homer to the marketplace, the reasom why everything is so high is because you have all agreed to participate in these margins so you can point the finger at each other like a big circle jerk. Here is the link for the toilet seat. ParmaRep, hilarious.
          http://www.bigjohntoiletseat.com/pgcart.pga?product=24456462CR

        • Terry Tree Tree

          If you were a  PharmaRep, you could provide a LOT of them yourself!

  • Paul

    “John” says he is “self insured”. I presume that means he has no insurance and depends on having enough money to pay for his care. That may work for him as long as he continues to have the money. But what does he expect to happen when he finally can’t pay? Does he want to be left without treatment?

    Reasonable people can differ about how much treatment should be available unconditionally. But I doubt that many people think it is none.

    I think we should set a standard for how much care should be a right, and then come up with a system that funds that. Over time we could adjust that standard, to include more or less care. But we ought to have that discussion in public.

    Is this “health care rationing”? Yes and no. No in the sense that you will always be able to get more care if you can pay for it. Yes in the sense that some things are not guaranteed. But every system has rationing, including the current one.

    • Anonymous

      Also John is not living in reality. He might be able to afford going to the doctor once a year or less but tomorrow he could be in a car accident and then incur huge health care costs. Just having a multiple leg fracture can cost over 20K. John is living in a libertarian dream world.

  • Leigh Winston

    Now, medical decisions are sometimes made by private, sometimes For-Profit insurance companies.  Do they worry you *less* than the government?

    • TomK in Boston

      No, they worry me MORE. Another righty script, going back to Reagan, is “the most frightening words are ‘I’m from the government, and I’m here to help’”. Sorry, I disagree. Personally, I’m a lot more frightened to hear “I’m from United Health” or “I’m from Bank of America”. I have NEVER encountered a civil servant with the arrogance of the corporate drones.

  • TomK in Boston

    I’m not optimistic about logic asserting itself into the class war, but anyone without ideological blinders can figure out that it’s not a coincidence that we have the highest health care costs in the world with mediocre outcomes, AND we have the only system with the corporations in  charge. Is it really so hard to understand that subsidizing the corporations is the problem?

    Medicare is the most efficient component of our crazy system, because it doesn’t enrich the corporations and their elites. The solution is medicare for all.

    The righty script about “rationing” is just smoke. Intelligent choices of the best procedures are essential, but the right screams “rationing” while they scream about the horrible deficits out of the other sides of their mouths. However they don’t care about the real rationing, which is being uninsured or underinsured because the corporations charge so much. Ryan’s plan to replace medicare by vouchers that won’t keep up with increasing costs is real, vicious rationing. But hey, it might be necessary to keep taxes down on his rich supporters.

    • William

      Who establishes the mandates that the insurance companies must make part of their plans? A recent example was giving free birth control products to women. Why mandate that? Won’t that increase the cost for everyone?

      • Terry Tree Tree

        The resultant health-care costs of those non-prevented children won’t cost MORE, than the birth-control pills?

        • Terry Tree Tree

          Will Child-Molesting and Child-Abusing priests offer to ‘take care’ of the children?  Would YOU let them?

          • Modavations

            What % of Pervert Priests were Democrats.What % were Republicans.It’s obvious you were molested.Why don’t you tell the story and get it off your chest.You whine and whine

          • Terry Tree Tree

            Perverted priest is a perverted priest!  Do they register as Democrat or Republican?   Would you  trust one to tell the truth?

          • Modavations

            I think you’ll find they are 100% democrats.Republicans are businessmen,not social workers

          • Gregg

            This is the impostor.

          • Modavations

            Sorry Gen.G,it is me.I hear the cry daily.I just want him to tell the tale and move on.

          • Gregg

            Impostor.

          • William

            Would child-abusing teachers, lawyers, college football coaches “take care” children? Would you let them?

        • William

          The cost of medical care goes up with the false idea that “it’s free”….

      • TomK in Boston

        Good thinking, William. Requiring what is freely available in the rest of the world must be what makes our system the most expensive in the world. 

        • William

          Nothing is freely available in the rest of the world. Someone pays, as witnessed by the financial implosion of the EU.

    • Terry Tree Tree

      REVEALING Analysis!

  • Bruce

    To the “liberty” loving skeptic, 40-50 million uninsured Americans is a national disgrace.  The health care market perhaps more than any other demonstrates the perverse incentives, gross inefficiencies and inequities inherent in a strictly free-market approach  Without meaningful reform like that initiated by Obama, the health care system is both economically unsuntainable and morally unacceptable.

    It is patently absurd to suggest that we cannot learn from the successes of every other civlized, Western democracy in the world that has balanced cost containment, quality and access and found a way to finance and deliver health care as a human right.

    The Affordable Care Act is a beginning and a step in the right direction.  Efforts to make it “Obama’s Waterloo” will hopefully backfire as the electorate wakes up and demands that their leaders exercise the imagnination and will needed to overcome an ideology based on wealth concentration and the “virtue of selfishness.”

    • Anonymous

      Bruce did you not get the memo, we Americans are “exceptional” and the market will sort everything out.
      The weak will die and poor kids will clean up the mess.

      • Bruce

        Yes, I understand Newt has gone back on his criticism of “right-wing social engineering” and is now advocating that poor kids do just that!

        • Modavations

          His proposal was to teach poor kids, a work ethic.They have no role models.70% of blacks are born out of wedlock(90%in the ghetto),I learned through mowing lawns,snow shoveling drive ways,,selling retrieved golf balls,selling lemonade.In this day and age, my parents would have been liable for allowing me to work while underage

  • leftofcenter

    How’s this for a double standard? Recently, a new Republican congressman was asking about the ins and outs of being on federal health coverage vs. private. He was told that there would be a one-month gap in coverage as he switched. He was livid and demanded to be put on federal coverage immediately.

    If I demanded coverage, would people listen to me or laugh at me?

  • http://freeourfreemarkets.org Steve Banicki

    As a nation that was founded by mostly Christians, one of our core principles is that it is a morale obligation of those that have been blessed with superior talents and gifts to help the needy. This includes providing basic health care to those who are in need but not in a position to afford it on their own. Christianity is not the only religion that preaches this belief. One of the basic Pillars of Islam as stated in the Koran is Giving Zakat which means ‘giving a specified percentage on certain properties to certain classes of needy people. 

    Our core value of helping our neighbor is why we needed to improve our health care system. Now we must decide what is the best way to do it. Another reason is that it is presently inefficient. The government is not protecting the free market to allow it to contribute to the solution..Lord Acton, the British historian, said in 1887; “Power tends to corrupt, and absolute power corrupts absolutely. Great men are almost always bad men.”
    Read More:  http://bit.ly/oA9LUi

    • Terry Tree Tree

      Think there are Christians of Muslims in the U.S.?

  • B. Barberi

    Points I would like to make:  Why reduce costs by lowering services?  Seniors are already being discharged too early.  You can’t send an ill senior home with noone to care for them.  Some would require 24-hour care.  Why not look at the inflated costs by hospitals and prescription drug companies?  How about finally making insurance and drug companies negotiate costs and control the overblown increases.  If we reduce costs, insurance companies and hospitals will will only increase charges to make up the money.  I realize we don’t have enough of a lobby to make this work like the hospitals and insurance companies, however I would like to see someone working towards these suggestions rather than reducing services to an already vulnerable population. And, if you insist on stopping insurance companies from refusing services to those with pre-existing conditions, there must be a control on how much the costs will increase.

    FYI, I have been working for and with senior citizens for many years and I know this information first-hand.

    B. Barberi, CT

  • Drew You Too

    Profit should have NO place in healthcare.

    We should be considered patients when we are in need of care, not customers.

    Administrators should make a living, not make a killing.

    How many of those who are against providing equal access to healthcare for everyone consider themselves to be Christians?

    The caller John from Montgomery demonstrates how misguided and deluded the majority of Americans are when it comes to the topic of Healthcare.

    The Hypocratic Oath has become a Hypocritic Oath (AGAIN, Profit should have NO place in Healthcare).

    Good show, great guest, insightful discussion on the board. Thanks On Point and Dr. Berwick.

    • William

      There has to be profit or nobody is going to work in the medical field. Companies don’t create MRI machines because they have nothing else to do with their money. They do it because they can sell it and make a profit. Like or not, that is how the world works.

      • TFRX

        A touch of hyperbole and you don’t get it? All the evidence about insurance companies inserting themselves between patients and doctors, to the detriment of human life, and healthcare outcomes,  and you think Drew is asking for free MRI machines?

        Are you a professional at taking things out of context, or just a high ranking amateur?

        • William

          Sure insurance companies are going to insert themselves between the patients and doctors. Do you think they should pay every bill that comes into their office? Doctors are not going to “pad” the bill(s).

          Are you just clueless?

          • TFRX

            The same way a 14-y.o. “right to lifer” often changes their tune after a pregnancy scare, your comprehension might be well served if your insurance company denied coverage after a hospital has saved your life. That’s the only way it’ll sink in to your skull.

          • William

            I have never had a problem with insurance. I pay my part and they pay their part. You most likely tried to scam the system and got caught.

          • Terry Tree Tree

            I am glad you have had no problems with insurance!  I know a LOT of people that have!  What I have seen of most of them, they are not the type to try to scam the system.  The scammers seem to be a LOT more sucessful!

      • NrthOfTheBorder

        Agreed – but to a point – which is when the system built on a profit model drowns out basic, and god forbid, preventive care. 

        • William

          I don’t think the Medicare system is built on profit, but more like fraud, corruption and inept people running it.

      • JMC

        their is a difference in profit and taking advantage of the system, if it costs you $100 to build a product and you sell it for 5k that is abusive. When that profit margin comes from tax payer supported programs that is called theft, or capitalism in our country, which is actually socialism because it is supported by a collective investment.

      • Drew You Too

        “Like it or not, that is how the world works.”

        I would contend that like it or not that is how the world DOES NOT work. Wake up and smell the Global Meltdown my friend.

        I might elaborate on my comment but judging from the responses from others to your statements it is completely unnecessary.

  • Moontide96

    To the caller from the SOuth: “liberty” will not pay your medical bills if you get cancer, or alzheimers, or if you have a major spinal cord injury!! You might want to seak with people who have lived thru these situations rather than buying into political speak, for your own sake.

  • leftofcenter

    Please ask the neocons who hate single payer health care these questions. Why are you entitled to the best coverage while your constituents aren’t? If you really emphasize with them, how come you’re not willing to switch from federal coverage to private? Have you ever been denied care because of a “pre-existing” condition?

  • leftofcenter

    If the neocons are so convinced that single payer is bad, then why are more pople going abroad for various types of treatment?If they really believe in “capitalism”, then by that logic not having singlepayer care is severely hurting  ourn economy. We’re losing business to our overseas competition. Any hypocracy there?

  • B. Barberi

    Another comment about Medicare/Medicaid.  Why do we lend 7.7 trillion to banks; start wars without paying for them; give money to countries that see us as enemies; give money for absurd subsidies?  How about looking at that waste instead of putting others at risk.

    • Modavations

      We pay 457 billion in interest on debt this year alone.The P.Office is going bankrupt over 6 billion,NASA went bankrupt over 16 billion.The debt is criminal.

      • Terry Tree Tree

        Post Office, and NASA, could have been supported by the $24 $Billion that ‘W’ ‘unaccounted for in Iraq alone?
            WITH $2 $Billion CHANGE?

        • Modavations

          The 457 billion in interest alone for this year,could have paid for a thousand NASA’s.Where are your priorities.Please change your name to Terence Tree Tree.Honestly,I’m always thinking you’re a woman

          • Terry Tree Tree

            Since you get ‘limp-wristed’ so much about guys, keep thinking of me as a woman.  I don’t want you getting ‘limp-wristed’ about me.
               I am tolerant, but NOT interested in guys! 

      • Anonymous

        Where do you think the debt came from?  BB left out ridiculous tax cuts in the face of 2 wars.

        • Modavations

          I take it you understand Pres.Obama extended the Bush tax rates for 2 more years.I take it you understand he wants a FICA tax holiday to continue.FICA pays for S.Security.Noone even noticed the original tax refief,as it came out of your paycheck each week.If the Pres.were savy,he’d have given the tax cut in a lump sum.The man is incompetent in my opinion,and so was Bush.I did not vote for,nor condone either

          • Terry Tree Tree

            Baby Bush PROMOTED those tax-cuts, saying they would CREATE JOBS!  Ten years of tax-cuts, WHERE are the jobs???  Congress held the Unemployment Extensions HOSTAGE, until President Obama agreed to the tax-cut extension!
               NOT the same, to even a third-grader! 

  • Modavations

    Medicare and S.Security are vote buying schemes,by the Dems.The first lady to be paid by S.Security had invested $5,000.00 and took out 20 ,000.00.When Medicare began in 1965 it cost 1.2 billion.In 1990 it was suposed to cost 12 billion,it cost 120 billion.Today it costs 520billion and Dr.Berwick says it’s 30% waste and fraud.That’s 130billion wasted per annum.

    • TFRX

      And there goes the neighborhood.

      • Modavations

        Try making a cogent argument.Look what’s happened to that other habitual name caller,Ultrax.

        • Terry Tree Tree

          Someone that you are calling ulTRAX, seems to be enjoying him/herself!  I don’t agree with a lot of the methods, but I don’t agree with a lot of your methods, either.

    • Terry Tree Tree

      How many paid in, and died without receiving Medicare or Social Security?

      • Modavations

        What,no plaintive shriek about the greedy rich.Chew some nails.You still sound like a whiney woman.Change your name at least

        • Modivations

          You are floating dangerously close to getting another spanking for abusive behavior.

          • Gregg

            Impostor.

          • Modavations

            This time it is Ultrax

        • nj

          Add misogyny to the long list of endearing Moda-troll traits.

            

        • Terry Tree Tree

          If and when I choose to change my name.

        • Anonymous

          You are obviously ignorant of matters of insurance and spreading risk.  But nice try to cover your ignorance with irrelevant insults.

          • Terry Tree Tree

            He was like that before the recent identity crisis!  That has been his/her method as long as I have been on here.

        • Terry Tree Tree

          Better to sound like a woman, than those WHINEY, GREEDY rich $BILLIONAIRES and $Millionaires!  Women have more INTEGRITY!

  • Modavations

    4 or 5 months ago I saw Herr Morse on C-span.He’s the guy in charge of tracking down Medicare fraud.He said they had cut 50billion worth of checks for outright fraud.He said it could be as much as 90billion in outright fraud

  • Modavations

    After Obama-Romney care my Blue Cross went from 646.00 to 1002.00 per month.In the first two years alone it jumped 42%(this year only 5%).The Boston Globe said emergency room care didn’t drop a bit and this, along was less cost, were the main selling points.

    • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

      It will go up every year with or without Obama Care. if without Obama care it will go up higher per year. trust me I know.

      • Modavations

        Nonsense,it accelerated wildly with the advent of Romney care.My original insurer USAA,left Ma.

        • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

          They left because nobody wants them. especially the Hospitals? Non-sense I am only Medicare Reimbursement specialist I don’t know anything in your perspective

          • Modavations

            They told me the mandates made business in Ma. unprofitable.Listen dude,anyone who thinks it’s cool that Tamil Tigers taught the Arabs about Suicide bombings(it’s hardly romantic)and then thinks they’re from Burma,not Ceylon,becomes suspect in all other matters

          • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

            LISTEN DUDE!!!! I work for a Hospital in Massachusetts doing my job for almost 20 years now and one of the people who an idea that Universal Healthcare is the answer. If you never work in your life doing Medicare reimbursement. Shut the hell up because you are making a FOOL out of yourself!!!!

          • Debbie G

            the medicare system may be poorly run and inefficient. That is called poor design. It is not a given that universal healthcare has to be badly designed or inefficient. 

          • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

            yes making medicare a solid plan for everyone is the right way. thanks

          • Modavations

            Anything the Govt touches turns to crap.There are no funds in S.Security.The 2.5 trillion surplus was spent and replaced by non marketable paper

      • Debbie G

        stop with the Obama care. We didn’t call our $$$$ stupid war BushWar even though we should have.

        • Modavations

          I believe Hilary,et al voted with Bush on the war

          • Debbie G

            Um, remember the weapons of mass destruction lies (not that I think that certain people didn’t want to just believe that).

          • Gregg
          • Modavations

            righteous

          • Modavations

            Bad CIA Intel is not a lie.I remember Clintons CIA guy(?) whispering into Bush’s ear,it’s a slam dunk Mr.President.Bob Kerry was going on and on about long distance missles,that just needed to be armed with nuke war heads,ready to blast off to Isreal.I reject your contention of lies.The intelligence was viewed by all the Dems(and  and they were all on board.The unfortunate aspect is that Cheney said the war would be short and cost 80Billion.Gen.Colin Powell also signed off after seeing the intelligence

          • Terry Tree Tree

            ‘W’ said, on national tv, that Saddam had weapons of mass-destruction, and he ‘W’ knew where they were!    Cheney said the war would be short, and would cost $80 Billion. ‘W’ said it would be paid for with Iraqi oil money!  ‘W’ said he was the ‘decider’, then took over 15 minutes to ‘decide’, when told the country was under attack, that he could leave being read to! 
              MUCH MORE!

          • Terry Tree Tree

            You believe inaccurately!  Hilary and others voted to give ‘W’ authority to use force, if ALL other options were tried.  They WEREN’T!  ‘W’ jumped into war mode, with OTHER peoples’ lives!  You notice he didn’t send his daughters, even though he compared himself to FDR, who had FIVE sons in WWII!

    • Terry Tree Tree

      Look how much so-called Health-Care costs have went up in states without it!

  • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

    The most complicated topic in American history is Medicare.

    Well, if you guys knows LCD or NCD, UB-04, NHIC,Inc or CMS web site you are qualified to talk about Medicare if you don’t
    you don’t what you are talking about.

    It all BS to me. Where is my Colonoscopy and MRI reimbursement or should I put a modifier 25 on HCPC.

  • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

    I want to ask why Medicare don’t pay Colonoscopy, MRI or mammogram? tell me please the American people wants to know.

    • B. Barberi

      They DO pay for these services.

      • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

        Not all of them.

        • JamesM2

          Depends on where you live doesn’t it?

          • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

            It depends what Diagnoses are covered by Medicare. not the place where you live.

  • Modavations

    English health is fine for the young,but you have lengthy waits.Many people,for instance, pay for the MRI(it takes too long)and then go to their govt.doctor with the images.Old people are denied care.I don’t disagree.Ask Lord Moncton how they treated his mum.The PM of NewFoundland went to Florida for a heart operation because the wait was too long.My pal in Halifax says “it breaks his heaRT WHAT THEY’VE DONE TO cANADIAN hEALTH CARE.fIDEL WENT TO sPAIN FOR care and the Spaniards had to import English specialits.The hospital in Mr. Moore’s flic was for party members only.Regular Cubans go the charnel houses.

    • Moontide96

      So do not look to the british system!!! Look at sweden or norway or denmark! In no other area do americans look to bad examples…

      • Modavations

        13-20 million white guys.That’s the population on NYC and environs

        • Terry Tree Tree

          So?  Relevance?

    • Debbie G

      It is not always as bad in the UK you sometimes hear. A relative’s father had extremely good care suffering from MS. But the problem with Britain is they assign doctors in a sector AND you don’t pay anything at all up front.. French system is better.

      • Modavations

        My uncle is a blood guy in Paris.He always wanted to come to the US,because the French govt.dictates his wage.In confidence,I don;’t know what his pay was,but he appeared affluent to me.

        • Debbie G

          blood guy? vampire? or phlebotomist?  Any way I would agree that a lot of health care professionals can be underpaid in France if you can believe that…Not all. And anyway they get many other benefits in addition to salary. Notice the lack of French people freeing France to come to the US (many of the the ones who do usually are rabid rapacious people who come here because they know they can get away with a lot–or else they just love LA/and California and NYC)

          • Modavations

            The only American I ever heard of who moved to France, was Johnny Depp.I love all of western Europe,but the T.V. sucks.It’s also 35% more expensive over there.They charge $8.00 to dry clean a shirt in Bologna

          • Terry Tree Tree

            With all your tax-cuts, you can afford it! 

        • Debbie G

          I meant fleeing France…not freeing…sorry!

        • Terry Tree Tree

          Must be the non-Moda, Moda, because this made sense, and was NOT bashing other countries’ medical, AND said the uncle in France seems affluent!!  

  • Modavations

    The fix is simple.Open Ma.to out of state competitors.We have 4 players who collude.We should have 400.Tort reform is needed, as this is precisely why doctors order all those tests.The Dem.Party is beholden to Trial Lawyers.

  • Modavations

    Go to the doctor, have your BMI taken and adjust for age.If your numbers are way out of whack,you’re monthly fee is up the whazoo.As your BMI gets more in line, you pay less per month.In one year,through market forces,the country would be nothing but “Jack Lalanes”Once you get the hang of working out and eating right, there will be far fewer pathologies in your Medicare years.

  • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

    Americans should start saving money and GO Overseas to be treated. The cost is almost 80% cheaper compared to Surgeries in United States. trust me a lot of Americans are doing it now.

  • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

    Remember Health Care in America is Capitalism. if you don’t have the money to have a surgery you will die paying your medical debt.

    • AC

      not this again.
      not in my experience, but i’m not getting into it….

      • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

        Did you actually pay nothing if you have a surgery?

        • AC

          yes. absolutely nothing. well, the original $25.00 co-pay….

          • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

            We are talking about hundreds of thousands of dollars not etsy bitsy surgery. Inpatient surgeries can cost up to $25,000 to $200,000 not those surgeries that cost is less than $25,000

          • AC

            Well I stopped counting when it was up to $800k. I know I’ve cost them at least 2x that in the past 6 years. I live more in fear of my insurance company cutting me off than the ‘medical sustem’ you’re trying to bash. My doctors are smart, caring & I can’t complain.

          • Gregg

            You seem to have much experience in this. I don’t think anyone says the system is perfect or even that it’s not severely flawed but it sounds like it works for you. It works for millions of others as well.   I’m curious, do you support Obamacare?

            I hope you’re better now. Good luck.

          • AC

            i can honestly say I am too ignorant, both of the details of the bill & the logistics of the industry to have a real ‘support or not’ stance. During the show on elder care, I found out that insurance companies can cap or deny you coverage & that Pres. Obama’s bill would not allow this, well -for obvious selfish reasons I want to lean towards support because of that clause alone & I do believe a civil society has the majority of its citizens in healthy working order (I can’t even pass homeless vets w/o feeling a wrongness), but I know that unless I really study it and learn the industry I shouldn’t voice my opinion.

          • AC

            why am i showing up as Guest? maybe because i tried to edit? anyway, i just want to make an amendment to my statement about not voicing my opinion, rather i meant i am not qualified to have an opinion….

          • Terry Tree Tree

            Thank you, on behalf of those homeless vets, that you have more compassion for that the Republicans that sent them into harms way, while waving the flag, and hearing KA-CHING!

          • Debbie G

            In 1988 I gave birth to a baby in France. Cost me $6 because I rented a tv for a couple nights (I was in the hospital-private room-for 10 days because they thought I might be developing an infection…never did though–it was great–baby in room because I wanted it that way, although she could have been in the nursery– food service, private bath/shower….this was a public hospital)

          • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

            AND THAT IS SOCIALIZE MEDICINE. You will be Shock how much the French pays for government day care facility. a dollar a day plus call in doctors  that visits you in your house still exist in France.

          • Debbie G

            Could you write in complete sentences? I know doctors there still make house calls. I am not shocked, I lived there (and my sister still does) and paid my taxes. It was no worse at the end of the month than it is here. We just pay different taxes. We have a great military here. 

          • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

            My friend from Germany saw some news about patients dying in the ER waiting room. She was very dissappointed of our healthcare system.

          • Debbie G

            Who isn’t disappointed in our healthcare system given what money is forked out for it?! :)….while waiting in the ER with my husband while he held his severed finger together, there was a man spitting blood into a bucket, coughing at the same time…talk about AIDS risks…this was in april 2010….

          • Modavations

            If you make 100,000 per annum in France you pay 50% tax rates

          • Terry Tree Tree

            With that kind of health-care you can depend on, and some of the other conditions they have, you could probably get by better on the $50,000 you have left, than you could do on the FULL 100,000 here!
               PLUS, you wouldn’t spend so much time and money trying to make sure you have health-care that will TAKE care of you, instead of the insurance and HMO executives!

          • Terry Tree Tree

            Similiar story for one of my grandchildren in Germany!

  • JMC

    take 100 million paying 500 a month and that gives us 600 billion towards healthcare, take the second 100 million that cannot afford 500 a month and have them 250 and that gives you an additional 300 billion or 900 billion a year to support our healthcare. The remaining 50 million can be covered by this amount as well although i am sure some of that population can contribute an amount to the system. does every person in the country consume $3,600 in medical benefits, I dont.

  • ClearThinking

    Please provide a list of all the life-saving and lifestyle-improving pharmaceuticals created outside the US in all of these healthcare nirvanas you keep talking about.

    • http://www.facebook.com/people/Seth-Miller/100000285649260 Seth Miller

      This is a pointless comment. The discussion has never been about where or how medical technology or pharmaceuticals are made it is about access, quality of access, and cost of access in the US. We can make all the greatest medical advances in the history of the world, but if people can’t access them it is pointless.  

      • ClearThinking

        Hardly pointless unless you don’t understand how it works.  We are subsidizing healthcare in the rest of the world by being the only one willing to pay for innovation.  The world is like the US in microcosm.  Medicare gets below market prices and the rest make up the difference.

        • ProveIttoYourself

          It couldn’t possibly be that insurance salesmen make too much, or that there are not enough docs being produced.  If you have skin cancer the oil derived form drug grade cannabis will cure it.  Why don’t you know this?  It has worked for lots of people.  Could it be because nobody wants a cancer cure that costs fifty dollars?

        • Adks12020

          Roche, Glaxo Smith Kline, Novartis, Sanofil, Astra Zeneka, Bayer…all in the top 10 pharmaceutical companies…all arcompanies based in other countries (Switzerland, U.K, France, Germany)….try again

          • Terry Tree Tree

            EXCELLENT!

          • PharmaRep

            Those are companies not drugs and, in any case, they all have major research operations in the US.  

    • Debbie G
  • Cime

    We will have a third world medical system! You have money, you live! You don’t, you die! What they want! For profit only!!

    • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

      EXCUSE ME DON’T UNDER ESTIMATE THIRD WORLD MEDICINE!!!! I WAS BORN IN THE PHILIPPINES. I NEVER DIED THERE FOR HAVING COMPLICATIONS OF MY LIVER. I AM STILL HERE. JUST LIKE CUBANS WHO ARE THE BEST DOCTORS IN THE WORLD. YOU HAIL YOUR AMERICAN HOSPITALS BECAUSE YOU GOT ALL THE MEDICAL MACHINES HERE BUT YOU EVER NOTICED THAT BEST NURSES AND DOCTORS ARE FOREIGNERS. MARCOS EVEN HAD A SURGERY IN THE PHILIPPINE HEART CENTER AND HE SURVIVED.

      • Modavations

        Didn’t Castro go to Spain

        • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

          Yes he went to Spain Via Rumors and Gossips Please Mod stop reading the National Inquirer.

          • Gregg

            The National Enquirer proved to be more reliable than The New York Times regarding John Edwards. For a perfect example of media bias compare that cover up to Herman Cain. 

  • http://www.facebook.com/people/Seth-Miller/100000285649260 Seth Miller

    Wow, the more I listen the more I realize that Berwick was the perfect man for the job. Unfortuantely, what that means is that he isn’t a politician he is truly an administrator; unafraid to say what might be politically dangerous. No wonder Republicans ousted him.  

    • Terry Tree Tree

      If you are NOT GREEDY rich, they don’t want you!  Unless you can be HYPOCRITICAL in your ‘conservative’ ‘Christian’ morals!

      • Modavations

        You almost made it a whole day without the “Greedy Rich”speel.Get the “Classist chip”off your shoulder.Teneo co.,run by Pres.Clinton was taking $50,000.00 a month from Corzine,for advise.You are confusing Crony Capitalismwith honest, small business and it’s pitiful

        • Terry Tree Tree

          I have explained the difference to you, Gretchen, and Gregg, before!  If you choose to ignore that, and continue to try to make me appear as an idiot, I see no way to help you, and no reason to try!

  • Hennorama

    Health care should be a right, not a privilege.  It’s shameful that a country as great as the US has citizens and residents dying or otherwise adversely impacted due to lack of affordable care.

    Politicizing this topic in order to maintain the profits of health care insurers and providers is not the answer.

    Paying for outcomes rather than volume is definitely the better way to go, as provided for in the Patient Protection and Affordable Care Act.

  • Quadraticus

    The math of the individual mandate is simple:

    (1) Add more patients (=demand) to the system.
    (2) Keep the number of doctors (=supply) the same to satisfy AMA lobbying.
    (3) More demand + constant supply = higher total payments.

    This is economics 101: no fancy analysis required. Note that it says nothing about the cost to individuals, only that the total payments into the system will go up.

    As this is doomed to failure, people will scream for a single-payer system. What happens then? Again, the math is simple:

    (1) Single payer systems save money by ratcheting down compensation to providers (doctors and researchers).
    (2) This reduces the incentive for people to go into medicine and medical research.
    (3) Same demand + price controls = rationing through reduced supply.

    Again, econ 101.

    Universal coverage is something that is highly desirable (except to Rethuglican douchebags who think the poor should just die), but it has to be handled at the boundary (e.g., through charity) or one of the above two dynamics will occur.

    • Modivations

      The obvious problem then if you are to be considered seriously is the AMA protecting the value of it’s monopoly by maintaining an artificial scarcity of professionals. Just another example of a lobby for the rich screwing everyone else they can to maintain and increase their wealth.

      Average income for an MD 1967 — $25k
      Average income of an MD today — >$200k

      France did it right, by creating an abundance of doctors.

      • CommonTime420

        It should be obvious to everyone that any time a group of people is put in a position from where they can put a strangle hold on the rest of us to increase their wealth they will do it. This is true of all groups, bankers, doctors, politicians, and everyone of us with very few exceptions.  That is why we need to be regulated like little children.  Because almost none of us are very adult in our response to being put in such a position, but we are geniuses at rationalizing why we should have more and more and how it is good for everybody — what a self-deluded prostitution of the capacity to reason.

        • Modavations

          Please reply to Ultrax.I’m laissez faire.

      • Modavations

        Ultrax again

        • Terry Tree Tree

          Too bad it wasn’t you, it made sense!

          • Modavations

            Terry I warned you about this guy.

          • Terry Tree Tree

            You warned me about you, by stating that you get ‘limp-wristed’ about several guys!  My one evident grace, is that my name makes you think I am female!
               What have I got to fear from ulTRAX?  I have remained civil, and refrain from name-calling.  I have even agreed with you, GretchenMo, Gregg, and others that I usually disagree with, on some points!

    • Debbie G

      I think one thing that should be done is to help those going into medicine with the cost of studying which is ridiculous and forces  them to go into debt and look for positions where they will make a lot of money…the main problem in the US. One problem with the current situation in France  (so that I can show I am balanced and there are issues with French healthcare :)) is that they are short on doctors in non-urban areas. That is a problem that needs to be addressed by compensation….

  • Modivations

    If you progressive scumbags want to see the real issue that should be being discussed here take a look at this.

    https://www.youtube.com/watch?v=8Yhm7gKdAm0&feature=related

    and

    https://www.youtube.com/watch?v=Icznf-z-xrQ&feature=related

    You guys never even touch the real issues, and just the fact that a moron like me can have hold your attention day after day proves you are nothing but a bunch of hypnotized chickens.

    • Modivations

      Obama snubs OWS-ers I love it.

      • Modavations

        This is not me

        • GeeMail5

          Who cares — get a life

          • Modavations

            This is also Ultrax under a psuedonym.If you want to see full blown psychosis, go to the Fr.Dec.2 week in review.I worry the guy is capable of violence

          • Anonymous

            I agree, get a life.

        • Modavations

          Ultrax is so psychotic he fictiously answers for me.He just typed “This is not me”.He has a variety of Tourettes

    • Modavations

      In a million years I would never use such language.Please go to Dec.2 Fri. week in review.Ultraz is a very sick dude.Read about his Transvesite Hookers from Bangkok and tyhe obscene talk of anal sex

      • Terry Tree Tree

        You HAVE used similiar language, and attitude, for most of the months that I have been on here!  Maybe not the points of view that have been posted in your name, recently?

  • Eldermuse

    My question to Dr. Berwick:
    As a nation, we took steps to protect children re: molestation, car safety seats, seat belts, etc.  Why then do we permit a climate of food pornography?  Cheap, highly refined, over salted, over fatted, over sugared food…..polluting our bodies, everywhere.  Health care will NEVER EVER be able to address the epidemic of obesity, diabetes, chronic diseases without FIRST dealing with the food pornography we must wade through daily.

  • Pshelley

    No wonder the Republicans wanted to dump Dr. Berwick so badly: he makes sense, is not confrontational, and understands and is willing to confront the real, not the imagined, challenges this country faces providing health care. This *is* a moral issue but one, I guess, that some people’s religious beliefs do not encompass. p.s. Anyone who favors the morality of insurance companies over that of the federal government (perhaps even at its worse) has never filed an insurance claim. 

    • Anonymous

      I hope you also look forward to never being able to sue for damages, wrongful death, or other malpractice issues once the Gov’t is in charge.  Right now you can sue insurance companies for bad behavior but you have zero chance to do so once uncle Sam is involved.

      • AC

        i don’t think they would do away with review boards – there’s no way, they’ll live in fear of bad publicity…don’t you think? There are many cases I can think of right now, mostly involving transit authorities, but it would be the same….

      • Terry Tree Tree

        Tort Reform will take care of that problem for the Insurance companies!  
            Instead of getting rid of the less than 6% of physicians, that commit over 56% of malpractice, the AMA whines about malpractice insurance increases!!  So do the insurance companies, as they raise premiums, with an extra percentage for the executives’ pockets! 
            Arbitration is another crime committed more and more!  97% of ‘arbitration is found in favor of the company accused of wrong-doing, by arbitrators that have a close connection to the wrong-doing company!

        • Modavations

          It’s the extra testing to mitigate a potential law suit,that’s the problem.This has been explained to you ad nauseum

          • Anonymous

            Complete BS.  Only a tiny amount of malpractice is ever acted upon.  Everyone over 40 has a personal story of it in their family and hardly any ever do anything about it.  And who do you think makes all the money on those “unnecessary” tests?  It ain’t the lawyers. 

            I defy you to find even one doctor who will admit to getting paid to provide anything that’s not medically necessary.

          • Gregg

            They still have to have malpractice insurance whether it is acted upon or not. It’s impossible to measure the cost of test and procedures that would not be done but for fear of lawsuits.

          • Anonymous

            According to Brandstad you wont be able to sue so there goes your problem.

          • Gregg

            I am assuming Obamacare will be repealed. 

          • Terry Tree Tree

            If the AMA had taken the licenses of the repeat mal-practicers, malpractice insurance would be about a third of what it costs now, or LESS!
               When your organization continues to authorize people to kill or maim people, there needs to be a cost to the organization!

          • Terry Tree Tree

            READ the post that you replied to.  I have faced this corrupt travesty myself!

      • Debbie G

        so you think that people who suffer from wrongful medical decisions in France can’t sue? wrong…
         

      • Anonymous

        Well lets see now, the republicans are all into tort reform, so I don’t see how this would be a bad thing for a republican.
        Just try and sue a huge insurance company and see what happens. 

      • Terry Tree Tree

        You, if you aren’t RICH, with the lawyer you can afford, against the teams of lawyers, insurance ‘pet’ professionals that will swear to whatever the insurance company wants them to, the $Billions of dollars they have accrued for NOT delivering health care, the ‘judges’ of THEIR choice, because you don’t know, and the rest of the deck stacked against you!
            Few have actually won against this arrayed army that DEFENDS and CONDONES mal-practice!  Really look into it!

  • CommonTime420
  • CommonTime420

    “Stop resisting the officer!”

    The LA, DC, NY, ATL, OKLD, Berkley police

    alienating a whole new generation :)

    ttps://www.youtube.com/watch?v=OcLJc9HKrpE&feature=related

  • Modavations

     Mr Ultrax is back.The man is a stalker and dangerous.At least impersonate me with  a correct psuedonym,ie,Modavtions,not Motivations.Kids,If you want to be shocked go the Fri.Dec.2 week in review.You can actually see Ultrax have a “nervous breakdown”.The stuff is rude and I’m surprised it hasn’t been removed.To all you guys who, after emptying your magazine of intellectual bullets and resort to inane name calling,this is what happens when ideology trumps logic.Mr.Ultrax,please get help before you commit violence.

    • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

      whatever Mod

      • Modavations

        When you become the target of a psycho stalker,don’t look to me for solace

      • Modavations

        Are you pround of yourself now?

    • Anonymous

      Please stop this.

      • Gregg

        The outrage is that WBUR doesn’t stop it. If I can prove it beyond doubt then WBUR with all their available tools should be able to as well. It’s hideous. If he were to start using “jeffe68″ and saying vile and perverted things (even on other blogs) you would feel differently.

        • Gregg

          Actually I talk big but I don’t have a clue.  The proof I offer actually proves nothing but I am too lame to understand why. Are you?

          • Gregg

            Not me.

          • Modavations

            Ultrax,please seek help before you commit violence.Greeg,everyone knows this is an imposter.

          • ConstanceDuke

            If so then why do you continue to tell this person how uncomfortable he makes you.  In my opinion you are just asking for him to make a fool out of you, and you have been helping him do it.  Just ignore him or her.

          • Modavations

            Here’s the difference between me and you.I hate bullies and would defend you to the hilt,were the shoe on the other foot.No need to reply

          • nj

            Impersonating other posters is inappropriate behavior in any online forum. There’s no defense for it.

          • Gregg

            Following up to above reply, that’s the point and that’s why I appreciate your nasty self. Others are defending it.

        • Modavations

          Gen.G,it turns out that Teneo Co.was being paid 50,000.00 per month to give Corzine’s Co.financial advise and acess to politicians.Pres.Clinton runs Teneo Co.This Crony Capitalism is not what I’m speaking of when I extoll Laissez Faire

          • Terry Tree Tree

            Sounds like some of the things that you have supported, except that it’s a Democrat mentioned!

        • nj

          I’ve been flagging it, too. It’s hard to understand what the moderator(s) is/are thinking. It’s hard to believe that there aren’t enough other people flagging behavior like this to trigger whatever the threshold is for moderator review, so one must assume that either the forum is unmoderated, or that they think there’s nothing wrong with this.

          Months ago, i was blocked for a while, presumably for something i posted, with no notice or explanation. I didn’t think anything i had written was remotely close to violating whatever unwritten rules the forum hosts might be operating by. A week later, i was unblocked, again with no explanation.

          If WBUR is going to have a forum, they need to commit to consistent monitoring and a rational, transparent, well publicized terms-of-use policy.

          That all said, there’s a raft of other posts, a number of them from the original, grammar-impaired Modavations, but also from others that violate what should be boiler-plate forum protocol—off-topic posts, spamming Web sites, linking to commercial sites, etc.

          They really need to have a clear policy and enforce it.

          • Modavations

            Thank You for making a reasonable stand.We don’t see eye to eye,but in my opinion you’ve shown some spine.Now where are the rest of the regulars.

          • nj

            You probably don’t want to thank me. If it were up to me, i’d wipe half of your obnoxious, self-aggrandizing, trolling, off-topic posts off the board. Most of what you post is worthless, disrespectful, misogynistic, useless. The rest is delusional or factually out to lunch, but those aren’t impeachable crimes in Forum Land.

            Your drama-queening over being afraid of some crazed cyber-psycho is symptomatic of your attention whoring.Still, impersonating another poster’s handle should rank near the top of prohibited behavior for any self-resecting forum.Way too much space and energy is being taken up with this sh*t, and it sucks the air out of the place.Forum moderators need to grow a pair and step up to the task.

          • Gregg

            Beautiful. Back atcha’. And I do appreciate it. I think you’re wrong about nearly everything you write. Your elitist holier than thou crap is myopic and uninformed IMHO. Cool, thanks again.

          • Gregg

            NJ, I could not agree more with your last sentence. The easy solution is for me to just go away and I’m sure you would not mind. I and Modavations seem to be the only targets. I don’t care about commenting on a blog where I’m so hated. The thing is my opinions have a basis and the times are begging for honest debate. This should be a place for that.

            The irony is ulTRAX’ comments only make me dig in. I cannot in good conscience be run off by a control freak that thinks this is his blog. I honestly think this guy is dangerous. I don’t like having my name commenting on gay porn sites. If not for that I would happily disappear, I don’t need this.

            My question: As much as you desire my comments be wiped off the blog, would you be satisfied if ulTRAX through his vile tactics ruled the day?

          • Gregg

            Thanks NJ, I don’t understand it. 

          • Terry Tree Tree

            I, too was banned, for no reason, that I can still discern.  We got it at about the same time.  Never got an explaination, just returned to status.
              Not sure what position to take on Moda’s situation.  He and Gretch both had been going FAR over the line that I think is proper, and that I personally observe!  With some of Moda’s and Gretch’s past postings, it’s hard to decide which is which. 
                I hope it clears up soon, as this is taking a lot of actual discussion of the issues, by polite opponents!

          • JuniorHigh

            Rules, Rules, Rules…

            You’re all behaving like a bunch of children.

            You complain about these jerks…

            You hate reading their frequent, misanthropic, trolling behavior…

            And your solution is a ‘moderator’?

            Sorry, mommy is not around.

            NPR doesn’t care what us peons say here or what generally takes place amongst these pages. 

            You folks are so ego-centric.

            Besides, they’re too cheap to employ the appropriate technologies.

            If you don’t like it, skip it.

            It’s frontier justice here.

          • Gregg

            If you stuck with the moniker “Junior High”  then you could be ignored. But you don’t.

        • Greggless

          I am outraged that a system hasn’t been employed so the frequent and valuable contributors of this comment board couldn’t eliminate Greeg and Modatroll months ago.

          A community should be able to jail or banish the ‘less desirables’ like Greeg, Modatroll, et al.

          Trolls like them pervert the discourse here.

      • Modavations

        I hope you now have an understanding of this character

      • Gregg

        Jeffe, please first expand the profiles of the two Gregg’s below for proof I’m the real one. But then, do me a favor and go to the Dec. 2 board and scroll down to the comment by the impostor Gregg that reads: “On second thought is impossible to defamate Gretch.  Nothing could be more insulting to him than his own display here.” It’s on the top of the second page. Expand that profile and look at some of the places this freak is posting under my name. Luckily it’s just my first name which is common but still. Don’t defend it. I don’t want to believe what it says about you. 

    • Modavations

      Oh hell, I should stop this really, I just got so envious when Gretch was the target of this clown and not me.  It’s just that, well you know, I always wanted to have my turn in the barrel, and even though I don’t have a shred of evidence to justify it, I have decided to accuse Ultrax of these heinous acts against my ego, because he is the one who consistently made a fool out of me in the past, even though I was too much of a numbskull to realize it most of the time. But since I met Gretch at the JuJu Aquarian Bar in Bangkok, it has changed my life, I always sort of secretly suspected that I was an a-hole, but little did I suspect that this very hole held the key to my future bliss.  I just love the feel of that masculine thrusting inside of me, it makes me feel wanted, sort of how that jerk using my moniker makes me feel more important than I am. Haven’t you noticed I almost had to beg him to abuse me again. I want Ultrax inside of me bad.  Please come back.

      • Gregg

        I can’t for the life of me understand how this is allowed. I’ve flagged it. Expand the profile and you will see none of the comments made by the one and only but you will see all of the vile impersonator’s (ulTRAX) comments. I am very disappointed there are actually others on this blog defending this. Does honest debate matter at all any more?

        • Gregg

          But if I actually had a brain I would realize that ultrax has been banned but that this person can’t be banned for some reason, but I don’t have a brain and since I met you at the JuJu Aquarian Bar the other night, I realized that what little brains have survived in me since I puked them all out at a frat party, have only been getting in the way of my true total enjoyment of your night in the barrel, remember to keep the bunghole properly orientated, or I get splinters, yeow!

          • Gregg

            If I was actually ulTRAX or a hacker I would know how to tell who was and wasn’t banned.

          • Greggless

            You’re so slick Greeg.

            You’d make a good rube.

            Oops, I mean lube.

          • Modavations

            Ultrax,who do you think you’re fooling

          • Constapations

            No one, but making you and Gregg the fool.

            Beautifully, I might add.

          • Gregg

            He says, admitting he’s ulTRAX.

        • Constapations

          Maybe, they just don’t care.

          I am dismayed more people are not expressing their own opinions of you.

          Apparently, most folks here think so little of you that you are not worth a comment or reply.

      • Modavations

        He’s only half way through the bottle.Give him an hour or two.Ultrax,please seek help before you turn violent.

        • Constapations

          J. Edgar –

          Fueled by your anger,  you have wielded divisive sarcasm as your weapon of anger.

          You have unapologetically treated many of the  commentators on this site with your brand of violence for too long.

    • Constapations

      J.Edgar -

      What’s dangerous is your disregard for civility and your lack of manners over the many months on this site:

      Your stupid, broken record, cut-and-paste trolling points…

      Your inane, barbarous, unsympathetic behavior concerning other peoples thoughts, ideas or experiences…

      Your unjustifiable, obnoxious and immature attitude toward polite discourse…

      You represent the illness in our society.

      You represent the lack of intelligence in our country.

      You represent our maladaptive, narcissistic and heartless culture.

       
       

      • Gregg

        Then debate him honestly. You can’t. You’re sick.

        • Greggless

          The stupid statement above proves your idiocy.

          A child could apprehend the deepness in the grain of both yours and Modatrolls, et al., unvarnished ignorance.

          Dozens of times over the last several months, many on this comment board have frequently and repeatedly kicked both your rhetorical butts on a multiplicity of critically debated issues.

          Both of you are too dumb to know it or your tiny egos just pretend to ignore it.

  • Debbie G

    Okay so in skimming comments below, why the heck can’t we do like the French (except that current medico-legal-pharmceutical-insurance-political environment wouldn’t allow it…). no waits (at least not for anything serious but I haven’t heard of waits for non-serious (my sister in Paris complained about 2 week wait for a pediatrician appointment for NON-health reasons–just a checkup..get real, here in Chicago it is months!!!)  One thing that people don’t get is how universal coverage frees you to take some risks in terms of going out on your own and working as an entrepreneur…I heard it said and I agree that for the first time countries like France actually offer more opportunities to move out of an economic status in large part because of freedom from health care worries….Case: my cousin-in-law in a French village lost his job as an after-sales service person (tire repair, lawn mower etc….). So being a great self-taught chef he opened his own restaurant – at age 50 and a smoker. 3 years later, he is still going strong. He could never have gotten loans here, let alone be able to do it but he doesn’t have to worry about HEALTH CARE …

  • Debbie G

    What people also don’t understand is the French system isn’t all one-size fits all…there IS private insurance which acts as a top up plan to the basic coverage. Employers offer it or you can buy your own if you are self-employed. The premiums are not insane like they are here….what does this mean? Well you don’t get significant dental coverage under the French health care system–private insurance helps significantly with that. You also have to pay your doctor up front in France (not in Britain) …and the system won’t always reimburse the full amount–insurance would make up the difference. Can’t afford doctor and don’t have insurance. Then you may need to go to a clinic…they are fine. Yes you might have to wait some (been there done that). But my husband waited for 8 hours in a hospital emergency ward in Chicago with his finger tip cut off (not just severed) and he was “rushed” because he worked in the system…
     

    • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

      Why Americans always assume that United States Healthcare is the greatest compared to other Develop countries like France,Germany or the Scandinavian countries? It is so arrogant to think like that.

    • Terry Tree Tree

      Another interesting personal story, with some pertinent facts!

      • Debbie G

        got many more personal facts and experience. Also have family in England and Canada so really have “seen it all”. My sister had to wait for NON EMERGENCY surgery in Canada. So, she waited, so she had surgery. So it was fine and she didn’t have to pay!!! Why not have to wait when it isn’t urgent?! If you want immediate because you are a child and cannot learn to wait then pay out of pocket in a private US facility :)…..

        • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

          For real. My Friend is a nurse in Canada she said doesn’t have to pay for health insurance she even Blasted our healthcare system

          • Yokohama98

            She does not pay? not even via taxes?

        • Terry Tree Tree

          VERY GOOD!! Info and personal experience, plus insight!!

  • commonsense

    the biggest mistake this country ever made was tying health care to employment.  My nephew is employed and pays for health insurance, but the co-pay and deductable are so high he can’t afford to use the insurance.  A one payer system insures that everyone has access to health care and you don’t have to be afraid of what will happen to you if you get sick.  In addition you can be treated before your condition becomes serious and more expensive.  This knee-jerk reaction to “socialized” medicine is ingnorant.

  • Cglushak

    The ACA has clearly broadened coverage and hopefully made coverage more accessibe land affordable for some.

    However, how does the AXA attack the 30% of healthcare dollars consumed by administration and bureaucracy. ASa provider and consumer, processes and red-tape abound and increase. MY impression is the ACA adds to this complexity and expense.

  • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

    The Universal Healthcare will work stop being so 70s and 80s
    Whatever the politicians said about Socialize medicine 30 years ago are FOOLS. If you don’t want socialize medicine you better start saving now before you reach 65 because when you reach your retirement age YOU WILL BE selling your house so you can be treated.

    What you heard before from Politicians about Socialize medicine are false. to PURCHASE HMO so those politicians can get a commission like Newt Gingrich and other Republicans who lobbied for the HMOs are the once killing Americans. Pass the Second Bill of Rights of FDR.

  • Debbie G

    Not only does France have electronic medical records, they are moving to electronic pharmaceutical records. It will be extremely fast. As is was the amount of time I spent 20 years ago in France on paperwork per doctor’s visit, was maybe 10 minutes. Maybe. that was to get 100% reimbursement. Now it is is faster… I just heard the problem..Dr. Donald said the care won’t be Government administered as is a good thing. The problem is that our Government isn’t very good at administering things…is the problem us (we are the government). Why are some cultures better at doing things like that….

    • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

      Because other countries’ governments are not controlled by HMOs and Pharmaceutical Greed. Money speaks if money speaks Universal Healthcare will lose.

    • Okitaris

      The government isn’t very good at any thing because much of the electorate do not know who butters there bread.    Believing that they do not need to be governed in there actions or the amount of wealth they take from the environment.   
         If we fail to govern our selves nature will govern us and that will not be pretty.
          But we continue to put people in government who do not like government and do every thing possible to make govern malfunction we are doomed to the trash heap of history, Systems that are not rational cost a lot of money  This applies to medical care and every other aspect of our culture and economy.

      • Terry Tree Tree

        Well Said!!

  • http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

    Universal Healthcare used to be called Global Health Care in the early 1990s.

    Senator Kennedy push the idea way way back in the 70s but NO ONE EVER LISTEN TO HIM UNTIL 2008.

    • Terry Tree Tree

      Some sort of Universal National Health-Care has been proposed for over a hundred years, as I understand it!! 
          President Teddy Roosevelt proposed it, but wasn’t the first that I heard about!   Forgot the first.

      • Gregg

        Other than the National Parks, Teddy Roosevelt was a lousy President.

  • http://freeourfreemarkets.org Steve Banicki

    How Is This For Lunch

    Happy Holidays!

  • Modavations

    I bet if you and me and Gretch the retch (even though you two are the same person) would stop posting in such a rude manner this person would stop his rudeness toward us.  We are always counting on the progressives to take the high road and not get down in the mud and wrangle with us hogs, and well, this is one guy who isn’t afraid to get down in the filth with us.  I guess he has had enough of us baiting any liberal who cares to express an opinion, and he is not going to let us slide on our dodo for brains knee jerk posts, so it may be in our best interests to at leas try to act like real humans even though we obviously are not real humans. Otherwise I have a feeling that every night is going to be our turn in the barrel, and much as I may like it, I am getting a little sore back there.

    • Modavations

      Honestly Ultrax,seek psychiatric help.

      • Constapations

        Simply marvelous. 

        After all this time, it’s a joy to watch you get marginalized.

        Keep up the good work.

  • Modavations

    I have a feeling that every night is going to be my night in the barrel until I learn some manners.  Much as I like it, I am getting a bit sore back there.  If I only had a brain.

    • Gregg

      I’ve flagged you until I’m blue in the face and either you hack through it like you add “likes” or WBUR is a joke with a rogue moderator. I am emailing and snail mailing the corporate offices. You really need to be stopped.

      • Gregg

        Glad to hear that.

        • Modavations

          More Ultrax

          • Constapations

            J. Edgar – Tell us, what’s it like getting asinine comments in reply to your own? 

      • Wimpified

        Besides you’re thinking being imbecilic, you’re behavior is childish – admittedly flagging people on multiple occasions. 

        Running to your corporate mommies and moderators – bet you use to ‘tell’ on your classmates, too. 

        Modavations maybe paranoid, but at least he doesn’t wear a skirt like you. 

    • Modavations

      What saddens me is that not one of NPR’s regulars find this deplorable

      • Gregg

        Me too.

        • Greeg

          Maybe Ultrax has sought help and that is why he hasn’t been around lately, but I can tell you this, as long as you continue in that vein (seek help etc.) you will have no peace here. 

          • Gregg

            I will not be threatened and bullied.

          • Greggless

            Get over yourself – you’re not worth the effort.  

          • Modavations

            More Ultrax

          • Constapations

            J.Edgar – How come your other monikers aren’t sticking up for you?

          • Modavations

            I have no other monikers and never have

          • TruthSquad

            sure you do sport. you’ve posted as fred manning. that’s what can be proved. you could have 100 other names.

          • Greggless

            So then your only ally is Greeg? 

            Pitiful, ain’t it?

      • Modavations

        I have always found your expressions and hostility here deplorable.

        • Modavations

          Ultrax is the speaker

          • Constapations

            Now you know how it feels when someone messes with your opinions.

             

      • Gregg

        Credit to TFRX who did say it was disgusting, I almost forgot.

        • Modavations

          Thanks TFRX

    • Modavations

      Just ignore him, and if you act nice maybe he will go away.

      • Modavations

        More Ultrax

        • Constapations

          What an excellent tactic.

          Three cheers!

    • Modavations

      More Ultrax

      • Constapations

        At least, he’s more right-eous than reading your right-justified-noxious-gibberish.

    • Terry Tree Tree

      Complaining, o self-proclaimed ‘limp-wristed’ one?
        Got to be careful what you ask for!

      • Gregg

        Don’t be stupid TTT.

      • Modavations

        Terry,did you post that or is this Ultrax.This does not sound like you

        • Terry Tree Tree

          Why NOT?

          • Modavations

            It sounded too immature for you.I thought it was Ultrax.Y

    • Modavations

      More Ultrz

  • Beth

    Dr. Don Berwick has exactly the kind of mind that we need in Washington helping us rethink our system. What a loss to our country and each and everyone of us that politics has shut out this great vision. 

  • Pingback: Hounded ex-Medicare chief Berwick back in Boston « Boston Health News

  • Ed

    Once your born, you’re a part of the health care system. You can’t NOT be a part of it — it’s impossible. All Americans have an impact on the system whether they pay or not. Formalizing health care it into a law is essential to the prosperity of our national liberty (life, liberty, happiness).

  • Fredlinskip

    There is currently no incentive for physicians, hospitals to keep costs down. Customers are not overly concerned as long as they are covered. It’s difficult for insurance cos to verify if charges are justified so they simply turn around and raise premiums. And of course, physicians, hospitals spare no expense to purchase all the latest gadgetry and tests, justifying this by saying patients health require this expense. It’s a runaway system.IMO   The Affordable Care Act is step in right direction. Considering the level of GOP obstruction, it’s amazing it ended up as good as it is.

  • guest

    Medicare NEEDS to negotiate drug prices with pharmaceutical companies. We (we as in, the American people who pay taxes) are getting screwed when Medicare pays top dollar for brand name drugs like Lipitor and Aricept. For example, Aricept costs $240/month and most elderly patients with even a touch of dementia get a script for it, even though the evidence that it works is extremely slim. Yet private insurance companies negotiate their prices with big pharma all the time. Why do we let big pharma walk all over our government?

    While we’re at it, after we start negotiating drug prices, we can lessen the blow to big pharma’s profits: Let’s eliminate some of their costs by making direct marketing to patients illegal. Have you flipped through a magazine lately? Have you noticed that half of the magazine is filled with drug ads? That like every 4th TV commercial is for a drug? Those ads are expensive, and the costs are passed on in drug prices. Eliminate them, and save big pharma money. Personally, I don’t want to decide what drugs I should be prescribed anyone. That decision is up to my health care provider.

    • Herbtechservices

      the prescription drug plan put into law by the bush administration took that out as a nod to big pharma.  that’s what you get when you vote republican.  the va can negotiate drug prices but medicare/medicaid can’t.  you can thank the previous administration for that.

    • Terry Tree Tree

      If you ask your doctor about every drug they advertize, your ten minutes with the doctor, that the insurance companies allow, will be gone, and you won’t get his/her diagnosis!

  • Lori Ann

    What I don’t understand is why so many people hate the idea of “Obamacare.”  I know that people resent the idea of “having to” pay for insurance.  What’s the other reasons?  I don’t get it.

    • Gregg

      It’s unconstitutional. There are over a thousand waivers so it is not universally applied. It is causing a tremendous shortage of potential doctors. It gives an inefficient government control over 1/6th of the economy. It was the most partisan bill of significance in history. If the government is charged with paying for health care then it must be responsible with our money. So, who decides if a 95 year old man gets a $250,000 surgery? Answer: A death panel.

      • guest

        Who told you that? 

        Why Unconstitutional? As far as I know, the courts haven’t decided about it and sounded divided by political views.

        Tremendous shortage of potential doctors?  Are you saying that Doctors choose the career to make money?

        So, who decides if a 95 year old man gets a $250,000 surgery? Doctors… like they do in all the other civilized countries that have a universal healthcare system…

        As somebody already said “Seems like many of those countries with universal healthcare still have
        better credit ratings than the USA. Apparently there is a way to take
        care of citizens AND stay solvent, even during tough times.”

        • Terry Tree Tree

          The death panel thing is their way of trying to scare people!

          • Gregg

            It’s admittedly a loaded phrase… but accurate.

          • Terry Tree Tree

            For over a hundred years!  INSURANCE EXECUTIVES ARE THE DEATH PANELS!!!

        • Gregg

          It’s true the Supreme Court has not yet ruled but the 11th circuit has. As of this moment the bill is unconstitutional. Please correct me. In the interest of honest debate, I’ll amend: I share the opinion of the 28 States that have filed suit that Obamacare is unconstitutional.

          I would not say that all doctors “choose the career to make money” but some do and I have no problem with that. If someone cures cancer with the sole motivation of becoming rich, cool. To become a doctor it takes years of dedication and tons of money. It’s naive to think without the prospect of big money there will be as many eager to face the challenge. It’s a problem.

          http://www.reuters.com/article/2010/09/30/us-usa-healthcare-doctors-idUSTRE68T67120100930

          “Doctors… like they do in all the other civilized countries that have a universal healthcare system…”

          I don’t believe that is so, government must play a role in the finances. But assume you’re correct, it’s the wrong answer. The decision should be made by the patient and family.

          • Terry Tree Tree

            And if your doctors prolong your cancer, to get richer?

          • Modavations

            Utter bull.Show me an example.

          • YourIgnoranceOurBliss

            Not just prolonging cancer, but creating the market for it.

            See one of the most recent posts today from:

            “TheBusinessOfIllness”

             

      • Terry Tree Tree

        Death panels have existed for over a hundred years!  Haven’t you heard of Insurance company executives?  Killing people for profit!!

        • Gregg

          I choose my insurance company. I choose whether to mortgage my house and sell my car. I choose how to spend my life savings.

          • Gregg

            That’s why I decided to choose my country. I hear there is real freedom from government in Somalia.  I will become Gregg the pirate and not have to put up with the government mucking about in my personal affairs.

          • Gregg

            Not me.

          • Modavations

            More Ultraz

          • Terry Tree Tree

            Your insurance exec chooses whether you get a life-saving, or life-enabling proceedure, medicine, or treatment!  They can find something in the policy [pre-existing condition], to disqualify you, sometimes AFTER your treatment, which could DEVASTATE you, financially!

      • nj

        Greggg catapulting Flush and Fox-so-called News propaganda again.

        • Gregg

          Just tell me where I am wrong.

          • Gregg

            Where do I begin?

    • andyagree

      If it makes the career of medicine less appealing to our best and brightest then it is bad for all Americans.

      • Terry Tree Tree

        HOW so?

    • Modavations

      It didn’t work.The cost was to come down and the use of the emergency ward,eliminated.Every crony capitalist ally of the president,was exempted

      • Terry Tree Tree

        It hasn’t had time to work yet!   Little of it is in operation! 

        • Modavations

          excuses,excuses.

  • Adrian from RI

    I would not want a Dr. Donald Berwick as my doctor because he is the kind of doctor who sees nothing wrong subordinating his hard won skills to the dictates of some mindless government bureaucrat; and he wants to herd all doctors into servitude to government bureaucrats. I would like to as my physician a ruthlessly honest doctor like Dr. Hendricks who quit the medical profession. Dr. Hendricks is a famous brain surgeon in the book “Atlas Shrugged” (page 683). “I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.” I wish all doctors would follow the example of Dr. Hendricks. Doctors are not the servants of their patients. No free man is a ‘servant’ of those he deals with. Doctors are traders, like everyone else in a free society—and they should bear that title proudly, considering the crucial importance of the services they offer. Doctors, as well as their patients, must come to understand that it is immoral to enslave doctors.

    • Terry Tree Tree

      Obviously Dr. Hendricks would NOT like the present system of bean-counters of insurance companies, with NO medical training, telling him what  to do, and how to do it!!  More-so than the government!
         He took the coward’s way out, because he COULD have found a hospital, somewhere, that would have let him practice surgery as he saw fit, I’ll bet!

    • Isernia

      Sorry to hear that someone from R.I., my native State, recites the right-wing anti-government mantra and has clearly drank the Kool Aid on medical care reform.
       In the mode of surgeons and proto-surgeons who as a class are noted for their arrogance and self-deification, Adrian’s remarks on the “enslavement of medicine” show his total ignorance of the FACT that the slave masters of doctors are not so much the GOVERNMENT or patients, but rather PRIVATE and profitable insurance companies, malpractice lawyers, and doctor greed that has stopped health reform over the years.
        The latter is evidenced by the very fact that a high percentage of MD’s go into specialization to support their multi homes, boats and expensive hobbies.
        Until doctors pay more attention to prevention, nutrition, a patient’s living conditions, latest medical research through their own learning not from drug company reps, connect to the patient instead of starring into the computer, we will continue to score poorly when compared to international health stats of developed countries.
         Adrian you took not a Hippocratic oath, but a Hypocritical oath.

    • TrentonPasal3

      Ayn was possessed of monumental hypocrisy, both in her private life and
      public.  The effect of her nonsense on her lapdog Greenspan is
      responsible for the wrong decisions taken by Clinton and others that almost lead to financial collapse and necessitated the bailout.  Despite all her rhetoric she signed up for social security
      benefits as soon as she was eligible, and that is the difference between
      fact and fiction.

      • Modavations

        To most sane folk,Ayn Rand is a god

        • Redherring111

          ^ It’s the delusion speaking.

        • Gregg

          After you Modavations, Ayn and Paul Rand are my gods.

  • Guest

    You’ve heard the old saying, “Don’t wish for something too much or you may get it.” Before you decide that the single payor systems in the U.K., Canada, and New Zealand are better than ours (despite their problems), perhaps you should read this study done on them.

    http://www.amazon.com/Lives-Risk-Single-Payer-National-Insurance/dp/0742541525/ref=sr_1_1_title_1_pap?s=books&ie=UTF8&qid=1323222604&sr=1-1

  • Hidan

    Sad case when we have Americans that want to help benefit the whole of America is considered not fix for service.

  • KnowledgeWins

    Seems like many of those countries with universal healthcare still have better credit ratings than the USA. Apparently there is a way to take care of citizens AND stay solvent, even during tough times.

    http://en.wikipedia.org/wiki/List_of_countries_by_credit_rating

    What I find more surprising, other than conservatives thinking the US is right about everything, is how little they know about the far reach of CMS. They don’t just manage Medicare and Medicaid. Get rid of CMS, thinking you get rid of the freeloaders, and you destroy heath care today.http://www.cms.gov/home/regsguidance.asp

  • Adam Martin

    PLEASE READ When I
    was 4 years old, a virus took away my ability to create insulin leaving
    me with type 1 diabetes. I am now 24 years old, and the number one issue
    I’m faced with isn’t managing my condition, it’s staying afloat
    economically due to the constraints put upon me by insurance.
    To save money while I go to college, I work an entry level job that
    offers me insurance. The issue is that base line insurance coverage does
    not cover diabetic supplies. They certainly cover generic medication,
    but insulin being a bio-medicine is not subject to potentially having a
    generic option. Furthermore diabetic supplies like testing strips are
    virtually never covered even by premium insurances offered for better
    paying jobs, and without insurance coverage range from $75 to $115 a
    month. Insulin without insurance ranges from $150 to $200 a month.
    How am I supposed to save money? I’m 24 years old and barely have a
    savings account because of these circumstances. I wish I could go
    without insurance, but I HAVE TO HAVE INSURANCE continuously due to
    maintaining a certificate of credible insurability, which allows me to
    waive my pre-existing condition should I need new insurance coverage in
    the future.

    • TTomson23

      Oh man, that need to maintain a certificate is just the kind of thing that pisses me off.  I am sick of dealing with corporations and their bull sh*t criminal policies. “Corporate policy” is just another way of saying, “Nothing personal but, screw you! But it is personal, it’s always personal, because it is always persons who are getting screwed.

  • Raymond

    Something I never hear about in discussions about the health care budgetary mess is how much money we waste every year on surgeries that have never been demonstrated to prolong life but definitely pay the surgeons well – specifically bypass surgeries and stent surgeries, as well as surgeries that have 40% or less success rates but again are demonstrably lucrative for the surgeons – specifically disk related back surgeries.  The statistics are clear, as far as I can tell from what I have read and from what people like Dean Ornish and Caldwell Esselstyn say, so it seems to me that if the surgeries are not going to prolong life or increase quality of life then why should we pay for them?  I’m all in favor of everybody getting what he or she wants, but I don’t see any good reason for the burden to fall on the health care budget when those kinds of surgeries ought to be paid for by the person who wants it.  That would save something like $150,000 per bypass surgery and $20,000 per stent surgery, and it adds up to a huge amount of billions of dollars annually.  After a long struggle to maintain his status quo even Bill Clinton finally gave in and listened to Ornish and Esselstyn and switched to a heart healthy plant based whole food diet, thus eliminating further need for cardiac surgery.  It’s no secret, it’s been published in almost every peer reviewed reputable journal in medicine, so why do we pay for these unnecessary surgeries out of the public pocket when they more appropriately ought to be paid for by the person determined to have the surgery done.  Together with back surgeries, I think we could save more than $100 billion each year.  And if you factor in all the money spent on drugs and medical management of people with high blood pressure, type 2 diabetes and all the related diseases that result from improper diet the amount of money wasted entirely because people are determined to eat garbage that has been proven to be really bad for them the savings could be enormous!  If people choose to eat in ways that lead to bad health outcomes that’s fine, but they should pay out of pocket for medical treatment that results;  if they choose to eat properly and take care of themselves reasonably, then they deserve free health care.  Why is that so hard for people to grasp?  Just curious.

    • Terry Tree Tree

      I heartily agree!  Surgeons have done un-necessary breast surgery, for NON cancer, and MANY surgeries that just fill their pockets, with no desireable results, or minor results for the major money!

      • PaxtonQuigley1

        I would be especially careful about lower back surgery.  I have such a
        problem and I spend about two and a half months each year unable to walk
        or stand because of it. Unfortunately according to both my doctor and a
        friend who reads scans for a living, about seventy percent of the
        people who have surgery for this common condition of a ruptured disc, end up
        worse off afterward.  However I also note that if you are someone like
        Bono, you can go to Germany and actually have this repaired.  And this
        is just the tip of the iceburg.  We are entering an era where the
        privileged and powerful will begin to live two and three times as long
        as the rest of us, by means of technology that is here already and
        almost here, like the ability to regrow your own organs on your own
        protein matrix, and other advanced techniques.  Even not the extra life the those who can afford it have access to would be reason
        for a planet wide OWS if it becomes known and understood by the masses
        who are still trying to comprehend the massive swindle pulled by the
        cabal of criminals in both government and the financial industry over
        the last four decades.

        Meanwhile the police are in the streets alienating a whole new
        generation, and ignorant that they are the puppets of the same people who in many cases
        stole a piece of their own pensions.

      • Modavations

        Bull.Show me an example

        • YourIgnoranceOurBliss

          J. Edgar – Really enjoy when you display your ignorance and stupidity for all to see.

          Here’s an example from just one physician and a couple a recent studies below which prove unnecessary surgeries are the norm:

          …a study just published in the Journal of Clinical Oncology reveals yet
          another alarming trend: during the past several years the percentage of
          women with non-invasive breast cancer (DCIS) who have their breasts
          removed entirely (mastectomy) has increased 188%! Since mastectomy is
          not at all required to treat the vast majority of patients with DCIS,
          the looming question then becomes “Why are all of these women having
          their breasts removed?”…

          In my own experience, when the Cancer Registry at my hospital, Clara Maass Medical Center in Belleville, New Jersey, reviewed my patients with DCIS they found that I performed 50% fewer mastectomies than other surgeons at my hospital, in my state and (on average) around the country. They also discovered that the recurrence rate for my patients was ten times lower than elsewhere in the state or the nation.

           - Dr. Kathleen Ruddy, Founder and President of the Breast Health and Healing Foundation
           
          http://ezinearticles.com/?Why-So-Many-Unnecessary-Mastectomies?&id=2189405

          Study of Breast Biopsies Finds Surgery Used Too Extensively:

          http://www.nytimes.com/2011/02/19/health/19cancer.html

          Lymph Node Study Shakes Pillar of Breast Cancer Care:

          http://www.nytimes.com/2011/02/09/health/research/09breast.html

          • Modavations

            Well, you certainly proved me wrong.

            What was I thinking? 

            I apologize for my frequent dimwittedness.

  • andyagree

    A minor point in today’s interview of Donald Berwick, but Mr. Ashbrook played the well worn soundbite of two (2) people in a large audience shouting “Yeah” when Republican debate moderator Wolf Blitzer asked Ron Paul if we should just let a patient die who had neglected to purchase health insurance. Mr. Ashbrook implied that this represents the Tea Party view – else why the soundbite? Neither Ron Paul nor any other Republican candidate has ever endorsed anything remotely resembling this, but rather than castigate Blitzer as he deserved, Mr. Paul gave a patient explanation for why this does not happen in America today. No one knows who these two “Yeah” yellers were, or if they really subscribe to “let him die” or if they just wanted to rile Blitzer. But that hardly matters. What matters is that the soundbite is useful in demonizing the Tea Party, or any opponent, on any grounds, of the individual mandate. I suggest Mr. Ashbrook conduct his future interviews without using propaganda as he did today.

    • Anonymous

      From what I’ve seen of the tea party they do a pretty good job of making themselves look like hard liners who will not negotiate on anything. I’ve also seen more than enough of them saying really nasty things in public meetings during the health care debate to make up my mind about this group. I find them to be pretty nasty folks from what I’ve seen, heard and read.

      • Modavations

        Bull.Look at the venue after a Tea Party Rally,as compared to a OWS site where the cleaners wear Hazmat suits.Tea Party rallys get permits,clean up afterthemselves,etc,.Tea Party are older,educated folk.TEA=Taxed Enough Already

        • Gregg

          Did someone say Tea Party? 

          I love Tea Parties!

          • Gregg

            Not me.

  • ElyseA

    I see the point about quality improvement as a sustainable means of providing adequate health care.  I also see the potential for (and the reality of) opportunities for loopholes in such a new and untested system.  Even now, VNAs and other home care agencies are scamming millions from the state while they falsify records and take advantage of the poor organization of government audit programs.  All this is supposedly already under the auspices of increased priority in preventative care.  If we are going to open the flood gates, we should get our life rafts ready.

  • Non-Utopian

    The man blames soundbytes for his inability to get his message across to the American people, then speaks in them himself (ie. ‘value not volume’).

    He’s also a clueless idealist thinking that we can pay doctors on their success rates.  Numbers will be fudged just like they are in all areas of government (ie, crime statistics, unemployment numbers, inflation), and government will not have the will nor the way to verify them.

    The bottom line is that healthcare reform is going to drive up health insurance costs because it addresses the cost of health insurance and not the cost of health care.  You can’t hide inflation in domestically produced services because they cannot be exported.  It is the reason why most people cannot afford a doctor, lawyer, plumber, electrician and higher education.

    • Terry Tree Tree

      Part of the reason that most people cannot afford, is because wages have lost pace with cost increases, while top executives’ pay and benefits have sky-rocketed!
         Skilled craftsmen/women  ARE NOT paid Hundreds of times their wages in 1970, Executive pay IS!

      • Terry Tree Tree

        Excuse me!  I meant SEVERAL times the 1970 rate!   Executives are paid hundreds of times the pay of those making the product, or actually providing the service charged for!

  • Dr Mike

    As a primary care physician, I believe that reform to our healthcare system is needed. The reform that was passed, some would say forced through, has good intentions. Unfortunately it seems as though the individuals most directly involved in the problems with healthcare as well as it’s resolution , were NOT consulted. 

    Everyday I am confronted by patients in a passively aggressive manner. The patient often “demands” the treatment or work up. Many have pointed to unnecessary testing or treatment. Unnecessary for whom? It is “unnecessary” until it pertains to you or your family.

    Ten or fifteen years ago CT scans were state of the art and just fine to evaluate for Rotator Cuff shoulder injuries or Meniscal Tears in knees. Now when I get a CT report, the radiologist states ” If evaluation of the rotator cuff tendons is needed, an MRI should be ordered” !  There is no evaluation. Did CT scans get worse? NO. The radiologist is protecting his/her license because the question on the stand will be: “Why didn’t you get the MRI doctor? Wouldn’t it have given you a better look at the problem , doctor?”  “Isn’t my client’s life worth the additional $900? ” 

    The problem or should I say 900lb elephant in the room is that we as a society want it all, demand it all, but lack the ability to pay for it all because of the predatory system that has been created.  We as physicians train and more often than not dedicate our “best  years” to achieve our medical degrees and then practice good medicine.  Unfortunately we are preyed upon by unscrupulous lawyers that force us to practice defensive medicine. I feel obligated to “build a case for my decision making” so that I can defend myself.

    Until this or any administration addresses this issue, I believe all attempts at reform are doomed to fail. ALL INVOLVED IN THE PROBLEM; FROM THE PATIENT, TO THE DOCTOR, FROM THE TAXPAYER TO THE LAWYER.  ALL MUST BE A PART OF THE SOLUTION. IT CAN NOT BE FIXED ON THE BACKS OF ANY OF THESE GROUPS, WE ARE ALL PART OF THE PROBLEM!

    • Anonymous

      Funny I was having this same discussion with my doctor the other day and he does not hold your view points at all.
      He wants an national health care system, such as medicare for all. The malpractice issue was not so large and issue for him, and he’s a GP as well. The stats also do not back up your claims as only 2% of the raising cost of health care is attributed to legal problems. Mind you the cost of malpractice insurance is huge. What is interesting is how the VA system is now considered the best system in this country. Personally I think our private for profit health care system is a joke and your tort issues are part of the problems that we have in solving health care in our country.

      The question I would ask you is why do other countries such as Canada, GB, France, Netherlands, and Germany have better health care systems than we do and they cover just about everyone with better results for less cost.
      Why?

      • Modavations

        Your problem is you view everything through a partisan lens.The dr.is of course right.The extra testing is because of the fear of lawsuit.Tort reform was not addressed because Trial Lawyers own the Dems.

        • Gregg

          Even Howard Dean admits it.

          http://www.youtube.com/watch?v=IdpVY-cONnM

          • Modavations

            I am Spartacus.

        • Anonymous

          The Dr gave a good well thought out response, something you should take notice of, and yet you completly missed the point of our exchange. That health care is a mess and that it needs huge reforms. Of course you have no idea what we are talking about do you. You only look for the partisan lens crap. I only mentioned the trot stat, I did not say I’m not for tort reform. I happen to agree with the Dr on this account. However I think it’s part of the larger problem and of course from a doctors point of view it’s bigger due to the way the insurance corporations extort money from them.
          Medicare for all is the answer or a system like the VA. Of course you will now reply with accusations of me being a socialist or communist. The problem with people like you is that your not really interested in finding solutions to problems. You only want to spout forth slogans and diatribes.

      • Dr Mike

        You are right. Our VA medical system is considered the best in the country.  Ironically it is based onbest practices already, but did you know that you as a VA patient can not sue the doctor caring for you?  That’s it! Let me practice good medicine and I will. Tort reform is very important and it is being sidelined because of the “stats” that you mentioned. Did you know that my malpractice insurance can settle without my consent? It is more cost effective for the insurance company to settle for $30K-$50K than to represent me even if I’m not liable? Then as a result of this being on my record, my insurance cost rises.  Anyone can make a claim. The trial lawyers know this.

        I’m all for “best practices”. But if I follow them to the “t”, then I should not be open to any claim if there is a “bad outcome”like in the VA system. I fear that the proposed reform will not have this. In fact, we as doctors/providers will be punished professionally and financially if we do not follow the “cookbook” and if we do and there is an adverse outcome, we are still open to lawsuit? You can not have it both ways. These are the tort reform issues. The “stats” that you mention, completely miss these important problems.

    • Elra

      My primary care physician has dropped Medicare in all aspects so now we have to pay full price if we go to him.  I tried finding a new doctor – based on my calls either physicians are dropping Medicare altogether (like my Dr) or are no longer taking Medicare patients.  The crisis in healthcare is already hitting seniors and the uninsured.  I am extremely frustrated by the vested interests who are failing the larger community.  We need a focus on health, not illness. 

    • Debbie G

      I think you need to throw in the cost of getting education…there should be subsidies for doctors willing to work in difficult fields or areas (or primary care). Lawyers in our dog eat dog society do make it worse (used to work for a malpractice/workman’s comp lawyer, what a racket that can be…). Other societies are more reasonable or forgiving –a real malpractice should be judged harshly but there should also be room for doing one’s best….

  • Joan

    It is shocking the Republicans stood in the way of this very moderate chief to head Medicare and medicaid Programs…

    The ARRP and other agencies connected to the poor and children should come out and shame the Republicans for
    their obstructionism in this nomination…

    Also, Obama should have led this goof fight to secure Dr.
    Berwickso that the American people would understand how the GOP is harmpering their access to affordable healthcare…

  • Joan

    addendum 
     
    The good news there is the fight is already well under way
    to make the Medicare and Medicaid program better & more
    affordable to those who need it and the Republicans will continue to receive the backlash from the public trying to
    oppose those efforts….

    • Dr Mike

      I disagree. Currently there is a push for “Best Practices”. It sounds good, until your the patient that is affected.

      Best practices is based on “cookbook medicine”. Unfortunately not every medical condition is the same everytime it presents. This approach comes between the pt and the doctor without being in the room. If anyone has experienced a worker’s comp. injury case you know what I mean.

  • Janalebiedzik

    Do an FMRI and look for a compassion. Bet you you will find a golden coins instead….. Call yourself a libertarian, complain I pay 18K a year for an insurance for a family of 4. You are what 40-ish and make 1/2 M. You are healthy. The reality hits when you are really seriously ill. Why is it that for a past decade it is the republicans ad libertarians who seriously harm the humankind? Why is a person who is obviously brilliant sacked?

    • Dr Mike

      I think you are missing my point. I do get the MRI when it is needed. The issue is that our society is too litiginous. Many doctors/providers go above and beyond what is necessary in order to protect their decision making at an added cost to everyone.

      I pay just as much as everyone else for insurance. In fact I pay two fold. My malpractice insurance is  $30K per year, and I don’t do any surgery. And yes I’m 40ish, I spent 12 years in school, and NO I don’t make anywhere near 1/2 M as a primary care doctor.  That’s just it…this misconception that docs make millions.  The ones that do are not in primary care and often have too much influence over the whole system.

      • Terry Tree Tree

        Why don’t you physicians get rid of the mal-practicers?  YOU have FAR MORE power than the VICTIMS, to get these criminals’ licenses revoked!
            Without the-less-than-6%, that COMMIT over 56% of mal-practice, your premiums SHOULD go down, and the NEED to be so defensive!

  • tncanoeguy

    I’m a day late listening.  The system is unsustainable and will have to change.  The monied interests (private hospitals, insurance companies, some doctors, members of Congress who take their money) are going to fleece the system as long as they can until it collapses.  No secret why we have the most expensive health care system in the world. 

    • Terry Tree Tree

      Amen!  Fellow Tennessean!  The GREEDY are going to keep looking for ways to fleece the system!

  • John Myers

    The Dr. is impressive.
     Our loss.

  • David S.

    At the end of the show Mr. Ashbrook said …”if we turn toward privatization rather than the Obama reforms”… to which Dr. Berwick reminded him that this is a FALSE DICHOTOMY – it was shocking that the host still did not get that point after an entire hour. As Dr. Berwick reminded us, it’s SILLY to say Obama’s reforms are “Government Run”, but that’s the spin that Republicans continue to push. 

    • CorporateillCare

      The above comment describes the often portrayed ‘convenient’ ignorance of Mr. Ashbrook and/or his ‘On Point’ producers.

      Still, Dr. Berwick is another example of how misaligned our governments goals are when thoughtful, intelligent and extremely effective people are marginalized and eliminated by political agendas.

      People who want to improve the system and affect positive changes are usually separated from the very positions that allow them to do so.

      Once again, the corrupt, corporate ‘invisible hand’ leaves it’s finger prints at the scene of the crime.

      No ‘smoking gun’ necessary.

  • Dan

    This was an excellent show.

  • TheBusinessOfIllness

    JOB ONE – Creating the market opportunities for profit.

    Here’s a prime example of what’s wrong with our government sponsored, corrupt, corporate ‘health care’ and insurance industries motivated by profit alone:

    Annually, 30 million men are screened using PSA criteria.  But two recent U.S. studies have thus far not shown any reduction in the death rate from prostate cancer…

    The number of Americans per 100,000 dying of prostate cancer today is actually higher (~25) than it was in 1930 (~18).  Wholesale screening results in earlier detection and treatment of a disease that would never cause harm.

    This is not progress; it is overtreatment due to overscreening…

    Billions of dollars are expended annually in overscreening, overdiagnosis, and treatment of tens of thousands of American men, resulting in loss of quality of life.  Only a tiny fraction of desperately needed money is focused on research.

    http://www.ascopost.com/articles/november-2010/how-do-we-eliminate-unnecessary-treatment-for-prostate-cancer

  • Pingback: Great Radio Show, Dr. Berwick! « As Our Parents Age

  • Gregg

    Newt says he’ll appoint John Bolton as Secretary of State. Can it get any better?

    • Gregg

      I am Spartacus.

    • Anonymous

      Are you forgetting that Gingrich was sanctioned for serious ethics violations in 1995 when he was speaker of the house. The vote was 395 to 28 with 196 being republicans. Newt has the distinction of being the only house leader in it’s 200 plus year history of having this happen. He was also fined $300,000. I don’t know I kind of like the idea of people running for president to be a little cleaner than Newt Gingrich. But hey, that’s just me.

      • Gregg

        This may not satisfy you but I think it was a witch hunt. He was hated and yes, I remember well and followed closely. 84 charges were alleged, 83 were dismissed and the last one was not significant but the fix was already in. He’s my choice and while I realize he’s not yours, I urge you to check in to the details.

      • Modavations

        The one and only one charge Pelosi got to stic,k was overturned by the IRS the next year.

  • Eb3design

    Medicine

    Create National Catastrophic Healthcare… call
    it “Medicare” we already have the letterhead.

    - Citizens:
    will be taxed $100.00 per mo per person, regardless of income. For this they
    are covered for anything not their fault and provide mandatory Medical/Dental
    checkups (as deemed by healthcare protocols and CDC), but are welcome to keep
    their existing coverage.

    - Employers:
    Make mandatory that all employers have to provide insurance coverage for risk
    their employment can cause (paper cuts to black lung), are welcome to pay for
    the ABOVE tax and/or keep their existing coverage.

    - Department
    of Health: Set up and maintain electronic Medical Files (reducing costs to
    Medical Providers and safe-guarding the information.  This also provides, the world’s largest
    health study, track medical trends/outbreaks and completely eliminates fraud -
    pays for itself.

    - Local
    Government: Create an Oversight Boards to keep medical and insurance
    providers in check.

    - Commercial
    Insurance Companies: Will administer the National Catastrophic Healthcare
    and will be free to sell Riders to Citizens and Employers at market rates

    - Costs
    (current total $3-trillion) $1-trillion paid by US Gov, Citizens/Employer
    $1-trillion, Commercial Insurance Companies pay the $1-trillion of waste (they
    won’t be paying it for long, THEY will eliminate the waste in quick order or
    charge it to the Riders).

     

    Conclusion

    In short… NO OVERLAPPING coverage,
    and everyone pays JUST their fair share. No one would be without insurance. And
    everyone is covered, for what really matters. 
    This will put people in high risk pools due to their lifestyle to
    outside the main pool, giving the it greater stability.

  • Modavations

    Let me straighten this out for all you vermin.  Everyone that I don’t like is Ultrax, and Ultrax thinks he’s Spartacus but he isn’t because Spartacus was defeated by Crassus, who was a free-market capitalist if ever there was one. No Ultrax is not Spartacus he is Snowball. I am a Greek baring gifts, so don’t look my gift horse in the mouth because you may see me and Gregg/Mo in there, hiding and practicing for our nights in the barrel. It has been wonderful wasting all your bed-wetting pinko time spewing like I do. I am one piece of work, and as you may note, I have redoubled my efforts to waste you time with trite diatribes, read them all, because you might miss something — then again maybe not. I only want to be in control of my own darn moniker is all.  Is that too much to ask?  I have time and energy invested in this false personna and sometimes at first people even take me seriously, and then I can, just for a moment, take myself seriously (though I know better — that’s how I always get in trouble).  Anyhow it is a little harder to take myself seriously with a garter belt and stocking on and doubled over in this barrel like I am, and I thank you for it — my trickster guru Ultrax. Is my bung hole lined up right? I can’t see from here.

    • Dr Mike

      With all due respect, your senseless ranting has no connection with the topic at hand. Your examples and opinions seem to wander about without any meaning. This is commonly described as “Flight of Ideas” often accompanied by thoughts of grandiosity. This is exhibited by individuals suffering from mental illness such as Schizophrenia. I reference the movie “The Fisher King”. He, Robin Williams,  too was fixated on heroes of ancient history.

      • Modavations

        I am due no respect. I am sorry you don’t quite have the grey matter to follow along here doc, but you are absolutely right I have delusions of grandiosity or grandeur as someone who speaks English would say, and I will take your word for it because you are a doctor and I do not know one doctor that isn’t themselves afflicted in a similar manner no matter their restraint in expressing their true inner faith in their own superiority.  I say your amateur analisis is spotty, but that doesn’t mean it isn’t spot-on, or that your abrasive prognosis will in anyway help me remove the spotting I have from santorum on the bottom of my barrel. Even so there’s always room for one more, because there is always room at the bottom of the barrel.  As the economic models I champion are so good at proving in practice.

        • Gregg

          Excellent deployment – ‘santorum’

          • Gregg

            Not me.

      • Gregg

        Dr. Mike,

        I think you are right with your analysis. The thing is the commenter above is hijacking other peoples names. The main targets are me and Modavations. We lean to the right and our comments are met with disdain most of the time although civility is important to me and it seems Modavations as well.  That’s all well and good, I don’t mind as long as the debate is honest. Using someone else’s moniker to mislead (and post on gay porn sites) crosses a line.

        Please scroll down a little and expand my profile by clicking the head. You can see all my comments. Then do the same with the reply (I am Spartacus) and you will see a completely different set of comments by the impostor. You can do the same with Modavations. The comments above and below yours are not Modavations. For some reason this is tolerated by the moderators.

        • Anonymous

          This is interesting Gregg. I looked at the profile and I’m not sure what to think.
          While I disagree with your politics I do think you and Mod have the right to post what you want. Provided it’s not hate speech.

          I’m also wondering what is going on here with the moderator. It seemed that On Point went from having a heavy handed approach to none at all.

          • Gregg

            Thank you Jeffe. All I can say is this is not fun for me. I hate having to pollute the blog. I don’t know what else to do, I can’t let it stand either. I am already too vilified for having a different view which is fine but I don’t want people thinking I’m a perverted freak. I have emailed and snail mailed WBUR. I will tell you part of what I told them. I will go away once this is cleared up. If I did so now, it would solve most of the problem but I will not be run off by a freak. Selfish? Maybe.

          • Gregg

            One more thing, I realize it’s just a stupid blog and my first name means nothing so let me clarify. I don’t want people to associate my heartfelt opinions with a perverted freak. It’s not really about me it’s about the views I represent.

          • Gregg

            Hey, you actually can think on occasion.

          • Gregg

            Not me

    • http://pulse.yahoo.com/_6IHV4MFIZSWLDYVHLMSSWKARZ4 Brennan511

      geographic origin is the truth in the margin.
      If you are Greek then why did you leave? and what’s wrong with that entitled economy?
      Ajax is indeed a bit of a conspiracy, but are you naviGating? or arriving quite free? the pile-up is the imperative policy.

  • Gregg

       I am a poor ol’ sot
     who’s opinions have
    gone to pot

        I think not – for I
     

    think right – without
     thinking for myself

    at all

       I believe my truths
      are abstract and
     above reproach

       when I’m faced with
      facts and figures,

    I hide like a roach

        I pine and whine
    for my younger days

       when people and
     things seemed to
    go my way

    • Gregg

      Not me.

  • Javierbonillac

    This is the clearest explanation of what is wrong in the US healthcare system. Dr. Berwick should have been a spokesman of Obama’s reform with a much larger profile. He explains things clearly and bravely. Congratulations Doctor. Now you are just another victim of special interest groups like myself.

  • ElyseA

    When I can get a bill six months later for a procedure I don’t understand for a problem I did not have and have no right to argue or contest it with health conglomerate my PCP works for or the health insurance company that holds me by the gonads/credit score… something needs to be done.  I don’t know what, but anyone who works to change that (in whatever capacity) is doing alright in my book.

  • http://pulse.yahoo.com/_6IHV4MFIZSWLDYVHLMSSWKARZ4 Brennan511

    Mr. Berwick, “Donald”?lol ok Mr B. I’d like to compose with thee, spectrums of truth and disfunctional society.
    My grandfather was A 3rd generation Milwaukee Dr. [ask or see]. He delivered many many baby-boomers and in his own office burned several moles off of me.
    In WWII he went to California with the Medical corps[?] to heal our Military Men from over seas.
    I alone grew up in California [just south of San Fran's "medicatEd spree"] and psych… visions found me. Societies Path to healthy reality. Visits to MY old world have immaculated the key.
    And to Wisconsin’s compassion I will return to COMPOSE the doctrin of American Destiny. I expect nothing and nobody… just me, to engineer the policy tree., & yes I escape he he he, [B]fore only she will creat a “we”.

  • Pingback: Berwick comes out swinging, but why now? « The Reality-Based Community

  • http://reinventing-america.blogspot.com/ ulTRAX

    My apologies to this forum for this off topic post. I find a need to defend my reputation.

    Gregggg, you’re a despicable SOB. I’ve just been strolling though your comments in this Medicare forum and I find no end to the false allegations you made against me that I was impersonating other users when in reality I’d left the forum. Without proof, you claimed some posts in the “profile”, including some racists and sexists one, were written by me. I’ve proven this need not be true. Disqus admits http://docs.disqus.com/help/108/that if some generic email address is used… like x@gmail.com, it will merge ALL the comments together in one profile even if written by different users who don’t know each other. That phony x@gmail.com address that I randomly picked and used for the first time, had previous connections to Italian iPhone users forums etc. The only person here I know has bragged about speaking multiple languages is Moda.

    I know from debating your politically that you have no real respect for facts and you often confuse your fantasies with reality. You bring to your personal accusations the same low standards of proof you use in making all your Orwellian Right claims. That’s bad enough.

    If you had ANY decency, you’d have retracted your scurrilous accusations by now instead of just saying… “So sad this happens to you and no one else. You’re using phony email addresses that happen to be used by others, how convenient.”

    I’d demand a retraction but I know that takes integrity… so I won’t hold my breath.

  • http://www.facebook.com/profile.php?id=100001032404683 Jean Devlin Haight

    Why are members of the Congress so opposed to the Omni Pod Insulin Pump? They’ve assigned Code Numbers that make it a disposable item!  Obviously they know little or nothing about insulin pumps!  They assigned the pod the code number,POD A 9274 ( this would make sense since it basically takes the place of the tubing that hangs down and gets caught in clothing!)  The Pod is filled with Insulin and is controlled by the PDM.performing the same action as any meter with any insulin pump! Again there is no tubing and the PDM signals the Pod with amount of insulin to be delivered to the person wearing the Pod!

    The political nonsense between the tea party & the republicans against the Democrats and the American People is ridiculous!  Maybe we need to look at what benefits and “powers” need to be removed from the elected “officials” in the Senate & Congress!

    Maybe when they refuse to allow us the best products available and complications occur the “HEALTH CARE COST SHOULD BE SENT TO THE MEMBERS WHO THINK IT TO COSTLY TO PREVENT THE COMPLICATIONS OF THE DISEASES CAUSING THE AND THE COST OF THE PREVENTION WHICH IS IN ANYONES POINT OF VIEW THAT HAS A WORKING BRAIN CELL IS MUCH LESS EXPENSIVE!

  • Rene Abril

    Its like this dummy: Republican legislators work for the Big Money, and Big Money is their constituency; not the voters, not the taxpayers, nor anyone else. When was the last time you invited your congressman and his spouse and children on a junket to a private island in the Caribbean?
    You haven’t have you? No.
    So, why should he do anything for you? You sure are dumb pal.
    I find it hard to believe that you don’t know how these dignified slothballs operate.
    You also don’t know that they right legislation for banks that “ensure” they make extra profits through fees?
    Things like $10.00 fees for every online savings to checking transaction after 6 fee-free transactions for every 30 day period?
    Dummy! Does that sound to you like they are looking out for you?
    That’s written into law.
    I was once a card carrying member of the Republican National Commitee. That is true and I am not ashamed to admit it! But a once honorable group of men somehow later became completely polluted by Big Money; and the rest, as you well don’t know because you are a dummy who refuses to listen to both sides of the argument, is this history being written: You enjoy the integrity of your present status, having over the years through learned behavior assimilated a thorough proclivity for the ignorance you enjoy as `bliss.’
    Since I can’t change your mind but I am of a generous spirit, I have a suggetion for you, and this is it: the next time, and there will be a next time, that an American political administration and its’ party deceives you through falsehoods into thinking that your child should die on foreign soil for their exclusive personal gain, it is in your best interest to support your loving and lifelong party, with happy shouts of, “Rah, rah, and hey, hey!”
    As stupid as you are, I am hoping this makes you feel a lot-lot better.

  • Pingback: Mulling Run For Gov., Berwick Says Government Can Be ‘Productive Force’ | WBUR

ONPOINT
TODAY
Aug 27, 2014
Russian President Vladimir Putin, left, shakes hands with Ukrainian President Petro Poroshenko, right, as Kazakh President Nursultan Nazarbayev, center, looks at them, prior to their talks after after posing for a photo in Minsk, Belarus, Tuesday, Aug. 26, 2014. (AP)

Vladimir Putin and Ukraine’s leader meet. We’ll look at Russia and the high voltage chess game over Ukraine. Plus, we look at potential US military strikes in Syria and Iraq.

Aug 27, 2014
The cast of the new ABC comedy, "Black-ish." (Courtesy ABC)

This week the Emmys celebrate the best in television. We’ll look at what’s ahead for the Fall TV season.

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Multi-millionaire Nick Hanauer says he and his fellow super-rich are killing the goose–the American middle class — that lays the golden eggs.

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On mixed media messaging, Spotify serendipity and a view of Earth from the International Space Station.

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