Nancy Desmond responds on CHT health proposal
posted at 4:35 pm on July 28, 2009 by Ed Morrissey
Yesterday, I wrote a post about the effort from Newt Gingrich and Nancy Desmond and the Center for Health Transformation to offer an alternative to Barack Obama’s health-care reform proposals, focusing on eliminating waste and fraud and finding a system of implementing best practices. In my post, I criticized a couple of their arguments. Today, Nancy Desmond responded to my concerns, and I’m happy to post her reply in full.
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Ed,
Thanks for drawing attention to the work of Newt and the Center for Health Transformation in your recent post on Hot Air. I hope you will allow me to correct a few points.
The “safe harbor” plan CHT is proposing would not rely on best practice standards set by “elites in Washington” as you put it, but instead by the standards that national medical specialty associations have already set. We strongly believe that physicians – not bureaucrats – should be setting best practices for other physicians. This litigation safe harbor would dramatically reduce the problem of defensive medicine which costs over $100 billion annually.
Second, while it is true that many doctors and hospitals have adopted electronic medical records, many more have not, including the vast majority of those who accept most Medicaid and Medicare patients. If these hospitals were electronic, the data could be much more easily analyzed for irregularities, much like the way credit card companies detect fraud. The amount of fraud in healthcare is at least 100 times that in the credit card industry, at least 10 percent annually (both industries exceed $2 trillion annually and involve millions of vendors and virtually countless items for purchase). It is $100 billion in Medicare and Medicaid alone.
Finally, on the issue of “wiser spending” on federal research, we couldn’t agree more. A major plank in our Alzheimer’s project is a change in the way science investment is scored and approached on Capitol Hill to take into account future cost savings and a clearer sense of national priorities in the way research grants are awarded.
I invite you and your readers to learn more at www.healthtransformation.net.
Sincerely,
Nancy Desmond
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I don’t think we’re really that far apart. I’m still troubled by the “safe harbor” approach if it rests on a government-approved panel of experts, or even a government-recognized panel for official purposes. It will still tend to force doctors to protect themselves by taking a one-size-fits-all approach to treatment, which is already a component of insurance policy. However, I strongly encourage people to read the CHT proposal in detail and decide for themselves — and it’s certainly better than what Congress is likely to produce.
Blowback
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FIFY?
mankai on July 28, 2009 at 4:37 PM
As I said yesterday, if you have a plan for health care that involves telling doctors and hospitals what to do, you and Obama don’t disagree in principle, just in degree.
doodleduh on July 28, 2009 at 4:38 PM
Is there a “not” missing?
Daggett on July 28, 2009 at 4:38 PM
I’m reading ‘wiser federal spending’ and wishing it said ‘less federal spending’. Better yet, ‘no federal spending’.
Vashta.Nerada on July 28, 2009 at 4:40 PM
Newt is an idea guy, but I don’t like him. He’s all about himself, sitting on a balcony in Italy with his wife and now his daughter, this Nancy Desmond. Newt best stay out of the primary race, he’s going nowhere. Ideas, yes.
suzyk on July 28, 2009 at 4:41 PM
I agree. Dictating patient care to physicians is a very slippy slope that I am not inclined to support. Ever.
search4truth on July 28, 2009 at 4:41 PM
so’s not to be accused of plagerism my suggestion from Lucianne applies here as well:
A Bill of this magnatude and potenetial for harm or good demands the need for a test period and test subjects. I suggest any healthscare bill immediately upon approval be tested on a sample of All Senate scum and staff, All Congress Critters, All occupants and employees of the Whitehouse to include the Presstitute corps, and all members of the Judiciary nationwide.
This would give a good national core group test.
After two years if it is great then expand it if not Throw all the above mentioned bums out and install new citizens in ther place with Term Limits and the military pay/benefit scale for all
dhunter on July 28, 2009 at 4:42 PM
Is that like a government arbitration panel similar to what was proposed in card check?
What could go wrong?
VibrioCocci on July 28, 2009 at 4:46 PM
Of course, it’s not just because of a “slippery slope.” It’s simply because health care is NOT a right. When someone like Newt comes out and says “We need to do SOMETHING, just not what Obama wants,” he plays right into the left’s hands. If both the left and right are telling the American people the government needs to get involved in giving them health care, why would they take Newt’s Obamacare-lite plan?
doodleduh on July 28, 2009 at 4:46 PM
Such crappola.
Electronic medical record set back your office expenses about 50-70,000 dollars for set up. Guess which doctors see the most Medicaid and Medicare, genius. Not the ones of have 50-70,000 bucks to spare. The ones who have 50-70,000 to spare have it because you can’t get though the front door with either Medicaid or Medicare.
Marcus on July 28, 2009 at 4:46 PM
Why do phrases like “safe harbor”, “lock box”, “guaranteed health care”, “managed health care”, “elderly care”, all these names seem always to be attached to my wallet?
And they never end up meaning what they “say”…there is always some other meaning a few years down the line.
right2bright on July 28, 2009 at 4:47 PM
Um…?
Wouldn’t “physicians” employed by gov’t to “set practices” be, by definition “bureaucrats” ?
franksalterego on July 28, 2009 at 4:48 PM
Let’s not leave out ACORN/brownshirts/community organizers/etc.
VibrioCocci on July 28, 2009 at 4:48 PM
While I haven’t visited the site yet, I would still like to know why neither the House or the Senate has any form of tort reform included. When most doctors have to pay around $100,000 a year for malpractice insurance, the cost they bill customers/patients has to be a huge part of the equation. But I guess reining in lawyers would be too much to ask.
Rovin on July 28, 2009 at 4:48 PM
Tort Reform and Deport Illegal Aliens.
DONE!
SDarchitect on July 28, 2009 at 4:51 PM
Excellent suggestion I will add that to the list tomorrow when I email my congress critters and senate scum, again.
Meanwhile hey RNC, McCain, how about sending me a donation request so I can happily blow it to pieces and send it to Sarah with a donation. I’ve found those requests make for excellent target practice. 38 wad cutters at 50′ turn them to usefull confetti in just 30-50 rounds.
22 cal rounds take 75 or so.
dhunter on July 28, 2009 at 4:53 PM
Where do malpractice lawsuits usually occur? State or Fedreal courts? My assumption is state courts. With that assumption, I do not think that tort reform at the federal level would make a difference. I know I do not support the federal government imposing tort laws on the states.
WashJeff on July 28, 2009 at 4:53 PM
Um, Marcus, that’s exactly what that statement said. :-)
bds1976 on July 28, 2009 at 4:56 PM
Then, I assume you are not complaining about the high cost of medical care.
Sporty1946 on July 28, 2009 at 4:58 PM
why does NOBODY talk about making the current health payment plan be actual health insurance…
MOST if not ALL of the current problems go away! Poof!
gatorboy on July 28, 2009 at 4:59 PM
Or, in other words, you will have a second opinion, whether you like it, or not….
…from a doctor, who has a third party’s interest.
Can’t ANY of these cockroaches stay out of my business?
franksalterego on July 28, 2009 at 5:01 PM
The conspiracy theory in me just says electronic records are a bad idea. I mean, did you guys even watch the Net?! If this passes Dennis Miller died for nothing!
We’re all just serfs and masses now, baby.
simon on July 28, 2009 at 5:01 PM
Ed, if we had taken the ‘one size fits all’ option in my son’s case, he’d have been crippled.
In the difficult areas of medicine, things cannot be parametrized, normal expert-system-style paths do not exist and ‘best practices’ cannot be applied. That does not mean that such ‘best practices’ cannot be developed for 80-90% or medical cases. But if you fall outside of those, the confinements of a ‘best practices’ outlooks can literally kill you.
michaelo on July 28, 2009 at 5:06 PM
Ann Coulter makes the most sense.
Johan Klaus on July 28, 2009 at 5:08 PM
And get the government out of healthcare.
Johan Klaus on July 28, 2009 at 5:12 PM
I like my doctor. I have him broke in right. He asks me no questions, just signs my one year prescription.
Jeff from WI on July 28, 2009 at 5:14 PM
Unfortuately all this good though (including Coulter’s) will be blown away when a few RINOs can be induced to sign off on government funded co-ops.
Then there will be a happy press-corps, much joy about the great One (no not Levin) fighting the good fight against the Evil Drs and Insurance Companies who have strangled and, yes, Oppressed America for so long.
And then they will be able to fight for Cap/Tax and every other fruitcake idea they’ve had for 30 years, and which will just manage to give them 51% of they voters dependent on them for their jobs and maybe even lives.
r keller on July 28, 2009 at 5:20 PM
How about we establish a system of objective law, repeal all the “man is his brother’s keeper” laws, and then allow anyone to come into this country?
Better economy without having to pay for illegal’s benefits. Win-Win!
doodleduh on July 28, 2009 at 5:22 PM
Ten years ago, we submitted a multistage plan to first include a picture and then an electronic thumbprint in to the medicaid card for our state.
You would have thought that we were proposing child molestation by the way we were opposed.
The problem with verifications is ONLY the correct people get health care.
Imagine if you had electronic records and someone came in to get their tonsils out, three times?
barnone on July 28, 2009 at 5:23 PM
I have a three part plan for health care reform:
1. Pull out a copy of the Constitution.
2. Find the place where government is allowed.
3. Remove government from every area not authorized by the Constitution.
DrMagnolias on July 28, 2009 at 5:27 PM
Not at all. I strongly beleive in federalism. The federal goverment should not dictate state tort laws. States should make tort laws, as many states have, for state courts. Federal laws should protect tort cases in federal courts.
WashJeff on July 28, 2009 at 5:28 PM
What about allowing for familes to purchase policies across state lines.
Forming non employer based groups to sign up for similarly provided discount plans that large corporations are given.
Allowing families to get tax breaks for not buying into the single option employer based plans and using and instead receive the tax cuts employers get to purchase our own health plans. you know, providing the kind of competitive insurance policies you get for auto, life, home owners, etc.
Avatar72 on July 28, 2009 at 5:31 PM
Not the best idea. After all, that would get government out of every state except the original 13 and it would get them out of every technology invented since the Constitution was written.
doodleduh on July 28, 2009 at 5:35 PM
Exactly.
gwelf on July 28, 2009 at 5:38 PM
I am all for this, but what is stopping this from happening today? The Federal government? State GOvernments? I tried to Google for an answer an it did not come back on the intial responses.
WashJeff on July 28, 2009 at 5:39 PM
The Constitution was not written for technology, but for human nature. It is a blueprint for our system of government, based on an understanding of how humans function and what is most efficient. The more local, the more politicians are answerable to their constituents. Regarding the number of states, I have no idea where you get the idea that the United States was limited in size by the Constitution.
DrMagnolias on July 28, 2009 at 5:40 PM
Depends on the system. If you’re talking about the “granulated data” programs that the government and insurance companies would like to institute in order to do data mining, this estimate is low by about half, for a one-doctor office.
If it’s a ‘hybrid’ program that just allows paper charts to be digitized, a single doc office can do that for about 10 grand.
The problem is, the government has not told us what type qualifies for the ‘significant use’ clause in current legislation, in order to be recognized as a legitimate system.
As it stands, that lack of information is a major roadblock to doctors interested in implementing electronic records.
EyeSurgeon on July 28, 2009 at 6:17 PM
Gawd,Newt, Powell, Mitt, Huck,there’s no GOPer to get excited about except for Sarah.
Jeff from WI on July 28, 2009 at 6:20 PM
I like it! Zero based governance. Let the feds petition to even continue the FAA or the FCC. Will make ‘em realize they work for the people and not vice-versa.
Christian Conservative on July 28, 2009 at 6:22 PM
I have posted this on another thread as well. This analysis was sent by a friend of mine. It lists some of the more egregious elements of the Democrats Obamacare plan:
A Few Highlights of the Healthcare Bill
This gives the government absolute power over your healthcare and how your healthcare dollars are spent (on other people).
Is this what you really want?
Be careful what you wish for.
Before you answer see pages 170, 195, 425 and 429
• Page 22: Mandates audits of all employers that self-insure!
• Page 29: Admission: your health care will be rationed!
• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
• Page 42: The “Health Choices Commissioner” will decide health benefits for you. You will have no choice. None.
• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
• Page 58: Every person will be issued a National ID Healthcard.
• Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
• Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (read: SEIU, UAW and ACORN)
• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
• Page 84: All private healthcare plans must participat e in the Healthcare Exchange (i.e., total government control of private plans)
• Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
• Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
• Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
• Page 124: No company can sue the government for price-fixing. No “judicial review” is permitted against the government monopoly. Put simply, private insurers will be crushed.
• Page 127: The AMA sold doctors out: the government will set wages.
• Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
• Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.
• Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll
• Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
• Page 167: Any individual who doesn’t have acceptable healthcare (according to the government) will be taxed 2.5% of income.
• Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
• Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL America n financial and personal records.
• Page 203: “The tax imposed under this section shall not be treated as tax.” Yes, it really says that.
• Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected.”
• Page 241: Doctors: no matter what specialty you have, you’ll all be paid the same (thanks, AMA!)
• Page 253: Government sets value of doctors’ time, their professional judgment, etc.
• Page 265: Government mandates and controls productivity for private healthcare industries.
• Page 268: Government regulates rental and purchase of power-driven wheelchairs.
• Page 272: Cancer patients: welcome to the wonderful world of rationing!
• Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
• Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
• Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!
• Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
• Page 321: Hospital expansion hinges on “community” input: in other words, yet another payoff for ACORN.
• Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
• Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
• Page 354: Government will restri ct enrollment of SPECIAL NEEDS individuals.
• Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
• Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
• Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
• Page 425: Government provides approved list of end-of-life resources, guiding you in death.
• Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
• Page 429: Advance Care Planning Consult will be used to dictate treatment as patient’s health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
• Page 430: Government will decide what level of treatments you may have at end-of-life.
• Page 469: Community-based Home Medical Services: more payoffs for ACORN.
• Page 472: Payments to Community-based organizations: more payoffs for ACORN.
• Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
• Page 494: Government will cover mental health services: defining, creating and rationing those services.
Wow! Talk about political paybacks.
And these are just the highlights. Prepare for absolute government power over your healthcare.
This is scary sh!t.
College Prof on July 28, 2009 at 6:44 PM
Ed:
I don’t want one size fits all be it from a board of doctors, lawyer, or politicians. I was able to be somewhat quickly diagnosed with my rare blood disease because I was able to have frank discussions with my doctor and she was not held back by a board telling her to treat me for other things first. It ran in my family and I had a good idea what was going on. My sister was a whole other case. Her husband is in the military and her doctor simply wouldn’t or couldn’t listen. They treated her for ovarian cysts first. Then gave her a completely uneccessary hystorectamy. Leaving in the Ovaries. The entire time she kept telling them test me for porphyria, it runs in my family. Nope, can’t do that simple 24 hour urine collection. Well, nothing they did fixed anything. So, they finally broke down and tested her. Guess what, she was positive for the porphyria. Doctors are already held to a standard of practice. This needs to be left at the state level and the feds need to keep out of it. If they start getting involved we will only have more and more people with stories like my sister’s.
boomer on July 28, 2009 at 7:07 PM
There seems to be a lot of concern about any recgonized body telling doctors and hospitals what to do. Insurance companies do that now, Medicare does that now. Even hospitals have review boards. I think the problem you all are hung up on is that nobody should set limits (hard or soft) on what your doctor can do. That is absurd. There should always be limits, either hard or soft. I absolutely don’t think the government bureaucrats should be advising or or controlling doctors. However, even doctors have a bell curve. Aren’t you glad that your insurance company is keeping an eye on the negative 3 sigma group. I have been treated by some of these -3 sigma fellows. They are nice, have good bedside manner, but are obsolete.
Maybe there should be a medical collegate board to do the same thing, but in a soft manner. Someone should question the need for popular (read easy, lucrative) treatments. However, if a case can be easily made for a treatment in an individual circumstance, then let it go forward. The problem gets exacerbated when the controlling group gets a God complex and won’t be questioned. Even our judicial system recognizes this by having an appelate system.
I think the ultimate problem is the propensity to litigate when something goes wrong. Don’t blame this on the lawyers. Blame it on the gutless and brainless few that should have had their guts and brains replaced when they were in treatment. Shit happens. Don’t blame the ambulance chasers when they make money off it. If there is an incompetant doctor, then let him be sued out of practice. He sure won’t be removed from practice by his “peers.”
Old Country Boy on July 28, 2009 at 8:53 PM
With our moral-less population?
Dark-Star on July 28, 2009 at 9:22 PM
Ya because anybody promoted by the federal government to watch over all doctors won’t get that complex will they.
I don’t know about other states but, here in Colorado if a doctor screws up he has a peer review done by the state and if he royally screwed up they can take his license. The peers that review the case come from around the state to review the case. So, you don’t get docs from only one hospital or metroplitan area. You get rural and city docs reviewing the case.
boomer on July 28, 2009 at 10:30 PM
Forgot to add that above. I’d also like to add that allowing these docs to be sued out of practice raises insurance premiums for other doctors and of course that cost gets passed onto the patient. Therefore higher healthcare costs.
boomer on July 28, 2009 at 10:33 PM
Most things (from the private sector) are.
We desperately need term limits in Congress. Ted Kennedy is the poster child for why.
IrishEyes on July 29, 2009 at 5:23 PM