President Barack Obama goes on National television at 8pm EDT to once again address the need for real health care reform, and the need to get something done soon. What’s that something? How soon? Let’s see. . . .
From the prepared text:
This is not just about the 47 million Americans who have no health insurance. Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job, or change their job. It’s about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. And it’s about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid.
So let me be clear: if we do not control these costs, we will not be able to control our deficit. If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket. If we do not act, 14,000 Americans will continue to lose their health insurance every single day. These are the consequences of inaction. These are the stakes of the debate we’re having right now.
. . . .
If you already have health insurance, the reform we’re proposing will provide you with more security and more stability. It will keep government out of health care decisions, giving you the option to keep your insurance if you’re happy with it. It will prevent insurance companies from dropping your coverage if you get too sick. It will give you the security of knowing that if you lose your job, move, or change your job, you will still be able to have coverage. It will limit the amount your insurance company can force you to pay for your medical costs out of your own pocket. And it will cover preventive care like check-ups and mammograms that save lives and money.
If you don’t have health insurance, or are a small business looking to cover your employees, you’ll be able to choose a quality, affordable health plan through a health insurance exchange – a marketplace that promotes choice and competition Finally, no insurance company will be allowed to deny you coverage because of a pre-existing medical condition.
I have also pledged that health insurance reform will not add to our deficit over the next decade – and I mean it.
. . . .
I understand how easy it is for this town to become consumed in the game of politics – to turn every issue into running tally of who’s up and who’s down. I’ve heard that one Republican strategist told his party that even though they may want to compromise, it’s better politics to “go for the kill.” Another Republican Senator said that defeating health reform is about “breaking” me.
So let me be clear: This isn’t about me. I have great health insurance, and so does every Member of Congress. This debate is about the letters I read when I sit in the Oval Office every day, and the stories I hear at town hall meetings…This debate is not a game for these Americans, and they cannot afford to wait for reform any longer. They are counting on us to get this done. They are looking to us for leadership. And we must not let them down. We will pass reform that lowers cost, promotes choice, and provides coverage that every American can count on. And we will do it this year.
Please add your thoughts and reactions.
Related posts:
- Liveblogging Harry Reid’s Press Conference on Health Care Bill
- Slowing, Killing Health Care Reform is about Politics, not Policy
- While Jim DeMint Vows to “Break” Obama on Health Care, South Carolinians are Going Broke Under Our System
- Obama to Congress: Insurance Requirement Okay with Public Health Plan Option and Cost Regulation
- More for Health Care, Less for Insurance Execs? Rockefeller Demands 90% Loss Ratio





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And we’re off and running.
zooooooom
Is it time to quote Pat and say “lock and load” – we must win this.
Is it just me, or is his stare harder and more straight ahead than usual?
He’s calling it health insurance reform instead of health care reform.
How does he know these things? The Senate and Blue Dogs are clearly going to make sure his promises are not true.
Hey Gregg, Great post title!
Seems like the camera is too low.
Now he uses “health reform.”
The public plan, always mention with the exchange, is not included in his remarks.
Aravosis can sometimes be a bit of a drama queen, but his story about what happened over the past couple of days with his eye in Paris kind of tells it all. One of the links (with a link to part 1 of the story). Worth a read.
Noticed that, too.
“…what’s remarkable at this point is not how far we have left to go – it’s how far we have already come.” Uh, that’s never encouraging.
what, no dial graph?
ooohhhh calling the r’s on their going after obama
and how those same r’s have great health care coverage on the taxpayer dime
yep – he’s making sure we see he is serious … talking a little too fast imho but even though I have all sorts of issues with this WH, it is sure nice to have someone who can speak clearly in the office for a change
SLAMMMMMMMMMMM DUNK
Is it me, or could he have gone harder after the GOPers?
Here come the lapdogs!
Yep, I think this is the big narrative.
Jeebus, did the AP guy get his face oiled ?
So how much will he give away to the health care interests in order to push this through?
AP up first – Congress trying to figure out how to pay for it, are you willing to share your position on their options … “you’re the one setting a deadline”
f.u. A.P.
it was great he said the POLS all have great helthcare
gotta be bipartisan, right?
Fooey.
Great line about paying for it – it’s about health care, not some budget BS.
Glad Obama pulled back from AP framing solely as a cost issue – this seems to be the new meme for pushing back on any good plan.
could have been harder but it was still a big shot across their bow.
calling them out in front of the press in a national televised presser.
uhh – the President is taking questions – eight minutes in.
there’s a new Sheriff in town…
what did GWB take questions – once occasionally – on the even or odd years?
I liked that … good thing to remind everyone of.
Wonder if one of them goddamn bloggers is gonna get a question?
anyone think any of the lapdogs will ask about coverage for what Atrios calls “lady parts” coverage?
I note no mention of deadline yet, maybe Dick Durbin is right and August is all but dead in that regard.
Q & A:
1. AP — have you told Congress what you want, and if not, why not? How would you pay for this?
O: cost guaranteed to go up; US spending about $6,000 more than other countries; we want the same deal.
2/3 of costs to come from within the system; rest from new revs is what we’re debating. Stil arguing for limiting deductions. .
Things I appreciate:
tying it into the broader economic crisis;
trying to explain “what’s in it for you”;
accentuating how much has been accomplished;
painting oppo as politically motivated.
Things I don’t appreciate:
No overt commitment to the public option, yet;
no call on Congress to forgo recess and do this by a date certain;
no direct rebuttal to the stupid talking points about denying care;
no calling out those in congress that put their donors ahead of their constituents.
waaaaaa, I want MY questions, waaaaaaaaaa
I thought I saw somewhere that Nancy is canceling recess until this gets done. Kids don’t like going without recess.
“This year.”
I hope Ed, Chuck ‘n’ Chip are here … /s
He’ll opposed paying for that 1/3 using taxes on middle class. Hasn’t seen anything from Finance Committee. He wants to see what emerges.
stop going too deep, Obama, for this public show. Man he’s a wonk(policy)
“…acceptable to Democrats, and, I hope, some Republicans.” Realism.
Happy about his support for the millionaire tax
Yep, Pelosi is ready to work through the recess but who knows what the Senate will accomplish within the next week …
Ez interviews Pelosi.
YUPPPPPPPP
Health plan that will double in cost, increase the federal deficit and not cover more and more people–That is the current system
Yeah, he’s great if your glued to the tv listening; but when he needs a sound bite, they’ll have to look for it.
Yeah, me too.
NEXT
Only if they were “scripted” like Bush himself said, two weeks before the Iraq War started
Health care reform = $ in people’s pockets
(Health care visits to the WH actually released.)
Baucus has fundraisers to attend.
When people look at teh cost of doing nothing, they will say “we can make this happen”
wth, flip flopping? Looks stupid.
Great stuff from Pelosi.
instead of CEOs pockets
Q. David alexander — why the rush? worried about delay?
A. I’m rushed because I get letters every day. They need help.
he doesn’t do sound bites. He can’t even do a tweet. He talks in compound sentences. Lapdogs have trouble following compound sentences. Chuck Todd can’t deal with it.
“I’m rushed because I get letters every day from families who get clobbered by healthcare costs.” Great answer.
Why the rush? GOP talking point alert!
slam dunk 2
Will anyone ask about the 2013 minor detail?
relax
Agreed. Nice to read the fighting words especially.
status quo
Yep. And that is gonna affect some of the FOIA fights in courts that I am interested in, such as the Cheney interview. Can’t release that and create a distractive shitstorm is my bet for their theory.
OK OK Raven Just what are your Questions??
Fantastic! Obama’s going to fight tooth and nail so you can go to an exchange and buy some insurance! Thank god you elected a progressive.
1) I’m rushed b/c I get letters every day from families being crushed by healthcare costs.
2)If you don’t set deadlines in this town , things don’t happen
Fascinating–here they be:
· Bill Tauzin visited the White House on March 5, May 19, June 2, and June 24.
· Karen Ignagni visited the White House on March 5, 6, and 11 and June 30.
· Richard Umbdenstock visited the White House on February 4, February 23; March 5, March 25, March 30; April 6, and May 22.
· J. James Rohack visited the White House on March 25, June 22, and June 24.
· William C. Weldon visited the White House on May 12.
· Jeffrey B. Kindler visited the White House on March 5, May 6, and June 2.
· Stephen J. Hemsley visited the White House on May 15 and 22.
· Angela F. Braly visited the White House on February 13.
· George Halvorson visited the White House on March 27 and June 5.
· Jay Gellert visited the White House on February 10, March 11, and March 20.
· Thomas Priselac visited the White House on April 3.
· Richard Clark visited the White House on March 24.
· Wayne T. Smith visited the White House on June 4.
· Rick Smith visited the White House on May 19 and June 2.
In addition to the above information, the White House visitor records reflect that Mr. Tauzin, Ms. Ignagni, Mr. Umbdenstock, Mr. Rohack, Mr. Kindler, Mr. Halvorson, Mr. Gellert, Mr. Priselac, David Nexon, and Rick Smith were scheduled to attend a May 11 meeting at the White House. We understand that all the individuals attended the meeting except Mr. Kindler, and that Mr. Clark attended as well. Finally, the visitor records do not reflect any visits by the following individuals: Ben J. Lipps; William A. Hawkins, III; or Robert L. Parkinson.
Some lines in the sand there – deficit neutral, reduce health care inflation, “bill that won’t work.”
“people are skeptical, because they haven’t seen a lot of laws coming out of Washington recently that will actually help them…”
oh yeah, I’m sure that that one was on the teleprompter….
Gawd, I love having a president who can speak, off the cuff, and make sense.
bipartisan these days means Party+1 I think. rethug bipartisan means Lieberman betrays his constituents yet again, maybe Specter too. Dem bipartisan means Collins or Snowe cross the aisle. Its all for show and a game. The real problem here are the Blue Dogs. And Mary Landrieu.
C’mon Barack, start smacking these Presstitutes around for their concern trolling …
To the Reuters guy … “Just how long does it take to get proper health care … more than 40 years ?”
What is reality?
I don’t want to say you should only meet with people you agree with already, but — Billy Tauzin? Really?
I assume YOU policy wonks know who the hell these people are?
your beverage of choice?
Endorses MedPac, very good.
Hey I see Laura Rozen behind Chuck Todd!
Is “Shiney Face” the new look in DeeCee ?
reality? WTF is reality??
Question about expanding coverage, good to see.
I can’t wait till Culture of Truth translates this….
Q3: Chuck Todd: Will it cover all uninsured? How far is enough?
A. Want to cover everybody, but without a single payer system, then you can’t get everyone, because of free riders.
Chuck Todd: Is this bill gonna cover all 47 million Americans who are uninsured?
Obama: I want to cover everybody. Unless you have a single payer system, you will not reach every single individual.
ROFL … Raven !
yep. Throw in Mark Pryor, Max B and a few others and we’ll see if we can even get a partisan bill passed.
healthcare reform since Truman…NOW IS THE TIME
Damn that bus hits a lot of people.
See, I ask hard questions!
Hardship Exemption?
For real. Tomorrow I have to come in the office with lard greasing my face.
It’s humid weather in DC tonite. Probably not enough powder on hand :-)
Stingers please.
That was a response to Jayt @80 —sorry.
You can have the magic bus for 100 English Pounds
No. . . too much!
Yup… Ya need an Einstein to answer that one!!! /s
Premiums higher b/c of “uncompensated care”
–Preventative care instead of remedial care–
Teddy Roosevelt was first bigshot to propose it. It’s been almost 100 years. He was a P(rogressive) at the time, not an R, though.
…Throw in Mark Pryor, Max B and a few others…
any suggestions as to where we might throw them?
RUT OH THE i WORD
You can’t blame the Repubes?
Watch me!
Seriously what is up with this answer? Muddle, imo.
And Chuck sneaks in a follow-up. . .
Relatively
Grow a Goatee, Spencer … for when Rachel has you on next ! *g*
Anyone else notice his right eye twitching?
Q4: Chuck Todd: Aren’t some of your Democrats jerks too?
A. I’m very appreciative that Grassley, Snowe, Inzeee are still holding up reform.
thanx didnt know that
Grassley serious in engaging? Hmm…no.
OK OK, enough softsoap for this press conference, let’s move on.
same diff…. Reality relativity sheesh semantics semantics….
This has to be repeated more, IMO … and how it will greatly increase the quality of life.
not that won’t get censored out of the thread.
I’ll be darned. Thnx for the link.
“Regional disparities”
you stupid fucking goobers!
That wire coming out of Jake Tapper’s jacket makes him look like a giant tampon.
rationing question? Seriously?
Jake the Jerk
WTF is this goofball talking about? sacrifice end of life care?
Obama should ask this nitwit where he gets his info. What experts say that?
Give up!!! No health coverage at all! or as the pres said 6k more than anyone else in the world.
Tool Time!
Asks the stupid Big Health frame.
Q5: Jake Tapper: Experts say there will be sacrifices — why aren’t you fessing up on rationing?
a. We just want to reduce unnecessary test that don’t do anything but raise costs.
Oh,I see the electronic medical records lobby rearing its head.
And it’s amazing that nothing is required to make Chuck Tood still look like a douchebag.
when in reality he really is a douchebag.
From his brain??
Funny how these sacrifice questios alway focus on patients, never on what very profitable corporations may have to sacrifice.
One pill makes
you larger
one pill makes
you small
Red pill or Blue Pill?
Pay for what works, stop wasting money. The conservatives will go crazy of this…
Wait. Tapper isn’t a giant tampon??
I’m getting kinda used to that.
Not crazy about the idea of medical records being more or less universally available…
I think that’s Raven’s answer : Matrix
OMG, profitable corporations sacrificing anything? Sacré bleu.
Darn–I thought the Blue Pill/Red Pill was going to be a Matrix answer.
He could do a better job of smacking down the rationing frame–a much better job.
Looks like Robert Gibbs turned off the A/C in the Press Room …
A used one, at that….
Obama’s Chief Counsel just released the letter of all contacts, on health care reform, as CREW requested. This is a link to the full-text PDF of the White House counsel’s letter.
Namaste
Hot yoga
you late bubbah
I really liked that one. Pefectly sensible – especially if you’re too cynical to believe the first one.
Like the framing of the current system – “why would you keep” something that will double in cost, not work, leave people out, etc.
Whoa and now — he’s actually talking about diff betw debt and deficit!
Can you imagine any of this from GWB?
Of course not. I don’t get the sense he’s particularly absorbent.
ow ow Jefferson Airplane!!! Lurves me some Jefferson Airplane and Grace oh oh I am going to faint… 67 all over again…
He’s lost the point. Now he’s defending the bailouts.
WYSIWYG.
The pill part
Petrovitch!!!
One pill makes you larger
And one pill makes you small
And the ones that mother gives you
Don’t do anything at all
Go ask Alice
When she’s ten feet tall
Of course that was before we had the little blue pills.
Idn’t all your credit/banking stuff already digitized ?
BO’s smoooth comment, adding “As an American …” with a faint smile.
Liz Chin-ee just fell over …
WTF is this goofball talking about? sacrifice end of life care?
Obama should ask this nitwit where he gets his info. What experts say
that?
was that a Chuck Todd question?
If so – please disregard.
ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ
also before most of us here needed it!
Press: “NO WE IMPERVIOUS TO LOGIC, it bounces off our C-Street provided shields”
move on!!!
This from a minister!
touché. I think you hit it just right.
In order to reduce the deficit we need to reform health care. That’s the line.
I hate when people refer to themseles in the third person. Pet peeve.
OK, that close on H/C reform and the deficit–that was good.
Raven agrees
Oh, brother, here’s the CBS tool – ridiculous Medicare question — do any of these people READ proposed legislation before asking their stupid questions?
Cuts in Medicare? This is set up for Obama to knock down.
Bingo!
Yeah, he’s a head-first kind of guy.
That’s one of them … the more important point IMO is “peace of mind”, like the OFA ad.
Q. 6: Chip Reed/CBS — what about Medicare cuts, but what kinds of scarifices are you asking beneficiaries to make, and why don’t you take this out of politics?
[Reed is clueless; there are not proposals to cut services to beneficiaries, and Obama has already proposed a strengthened MedPAC]
Chip…Pain, Part II
you seen the VT Country Store catalogue lately?
It’s everywhere. And my church does real sex ed programs—complete and honest ones.
lord, they sooo want this to be a bad thing for regular folks …. talk about propaganda … media is so far from neutral in their questions its stunning
yes…leave more money in MERKINS pockets
Obama is stuck in his own bipartisan trap. he simply cannot / will not argue for what really needs to happen.
Expect Congressional accountability?
Bwa-ha-ha!
WTF is ‘Reform’…? The only two words I want to hear is “Single Payer”…
Aloha Ya’ll…!
Chip reads all of Palin Tweets, to be well informed …
Medicare:
How about stop paying private Medicare providers a 30% premium so they can rake in premiums and then claim to go belly-up after they rake in their dough? How about not giving away the store with the Medicare drug benefit?
As commenter said above, those are already in the proposal.
There are no cuts to Medicare, that needs to be repeated.
I’ve never before heard anyone use the word incentivize.
they don’t care about the little people. And they think they will have their jobs and bennies forevah.
Eliminating the donut hole, another point that needs emphasizing.
GOTCHA on the FOIA question.
Uh-oh – Christy watzhername isn’t PAYING ATTENTION!!!
Does that extend to psychedelics?
where were all these confrontational reporters during the Bush era?
YAY! Negotiations on CSPAN – good questions all
Jeebus, thanks! I thought it was just me.
If this passes, who will buy all those expensive ads on the Evening snooze …
Ooops! Missed the letter, she did.
Smack the press.
It was as if she was set up.
…aaaaand that’s why they released the list of healthcare execs; to make whoever asked the question — which was 100% legitimate, BTW — look stupid.
hence the release of the list
Q7: Christy Parsons, Tribune: Why are you withholding information/transparency.
A. We just released the list, and you guys were taking pictures anyway.
Note Ms. parson doesn’t ask why Congress is negotiating the contents of the bills in closed committee meetings — all secret until mark up.
and Michelle Bonkers!!
Oh, honey, I so wish I could say that! What business are you in?
Boner meds
didn’t know that psychedelics were ever part of sex ed.
SPEW!!!
Can we get Nico Pitney to ask a real question ?
And we’re moving away from health care…
Q8: Question why we aren’t being harder on wall street? Would you support a fee on risky transactions?
Yeah, and that was when we had Owsley, too.
Harder line with Wall Street…?
Let’s see what Goldman says about that!
didn’t know that psychedelics were ever part of sex ed.
boy, do I have some stories for you.
they can wait, though….
No one seems to have noticed that Obama left the public plan out of his original statement — because it wasn’t one of the things they have agreement on.
“we were on the verge of a financial melt down because wall street . . . “
we still are because Goldman Sachs owns us all. Getting really pissed off about this I am.
—hard to type with kitten playing on my face and the laptop.
Well, maybe not so much the “ed” part.
Government. LOL
You lived in a different part of Urbana than me. And I would point out that White Rabbit was a brand of acid, like purple haze, orange sunshine. . . you know.
Huge, ugly issue!!
He’s dodging the answer about putting a boot on WS neck…
Interesting that question comes from a Bloomberg reporter …
who is this reporter–the dark haired woman that asked the econ question?
You’re being rhetorical again, eh…? ;-)
Yeah, not much money left after bankster and Afghan supplement. All those bases and $1 billion new base in Islamabad. Ah for a blogger questioning.
Chuck Todd rewarded for protecting Obama re torture exploration as distraction getting VIP attention. Cronyism with media. Obama seducing press corps. They are hungry for it.
I wish I could trust Obama. I just feel he is coaxing the electorate to settle and the corporatist with lobbyists prevail. Free market system.
Also, what about fraud. Yes, I think it is good for him to talk re efficiency, but fraud some by individuals, often by docs and companies. loopholes and lack of oversight.
People feel safe with their status quo insurance, BUT is their status quo insurance really reliable. When they need it, do they believe it will be there.
More regulated and transparent like you are regulating the banks, sir???? HAH!
And his time frame “this year”.
I had to run into the kitchen – has he mentioned public plan at all?
More Nico Pitney please.
Has he called out Mike Ross by name? I’m watching the time-delayed TiVo version… about 30 minutes behind. Ross needs the bad publicity from the Bully Pulpit…
The current year’s near $2 trillion deficit has almost nothing to do with healthcar and everything to do with the economy. Obama’s statement could be construed as demanding reform of entitlements, i.e. by cutting them.
If Obama was interested in what works he would be championing single payer because this has a proven record of success in many industrialized countries.
And to link the ‘threads’, can we do medical experiments on Goldman Board members?
Regulatory reform for finance-hey,if it takes as long as health care….
tuttle!!
While the music played you worked by candlelight
Those San Francisco nights,
You were the best in town
Just by chance you crossed the diamond with the pearl
You turned it on the world
That’s when you turned the world around
Barack Obama deserves to be analyzed on his own merits. He deserves the best chance possible. And it seems as though he is fully capable of playing multidimensional chess with all of the world’s problems and then having the solution come to light near the end, like when all the pieces in disarray in a rubric’s cube “magically” come into place at the hands of a master. Or in a “CSI” or “The Mentalist” episode, when the crime is solved in the last five minutes.
But more than one or two championship traits are needed in major league baseball. If the Yankees have great hitting and starting pitching, but lack defense or middle relief pitching, they will not be champions. If Mr. Obama—at this tipping point in world history—has great speaking skills and a near genius IQ, but lacks the uncanny ability of FDR to time his fireside chats both in pace and per crisis or lacks the personality traits of an LBJ to play all of his chips—put his foot down, his career on the line—at the right time, he loses—not only a second term, but the lives of hundreds of millions of people worldwide because of the coming climate change crisis and “life as we know it,” as termed by one of the foremost scientists, James Hanson of NASA, who has been predicting climate catastrophe since 1988.
For all of his coolness under pressure and knowledge of the problems at hand, Mr. Obama may be another Herbert Hoover, who, believe it or not—given his infamy as a buffoon—was elected by people who wanted to “let genius have its chance.” Hoover understood the problems of the Great Depression that began early in his term, in October 1929. Nearly all the programs or solutions tried between the Crash of ’29 and FDR’s first term, which didn’t begin until 1932 were copied by Roosevelt, but implemented better and harder. Hoover’s measured IQ likely exceeded that of FDR, but FDR had a sixth sense of how the general populace felt, what the political parties could take, when to use his bully pulpit—which should be Obama’s most potent weapon, and when to get down and dirty behind the scenes.
When Franklin Roosevelt took office, he was only 51, not that much older than Obama. But he had a gravitas to his voice, especially on radio, and a patrician’s air. He manipulated the media, not the corporations. Obama cannot manipulate the corporate media but does have a good command of the Internet. But there is a disconnect. No family sits around its computer to listen to one of Obama’s talks, like they used to when FDR gave a talk on the radio. When that happened, the streets were empty; everyone was listening to Roosevelt and was comforted and inspired by him. I’m sure the topic of his talk was discussed at water coolers the next day. Nothing of the sort is happening with Obama’s many Internet-propelled speeches to the nation. No one knows when they are scheduled. No families await his words. No one speaks of his talk at the coffee machine these days.
I did NOT know of this speech tonight. No one of my companions did yesterday or all day today. Not the way to do it, Barack.
And that’s what is needed, if it’s not too late already. Obama has to make HIS speeches as highly watched or listened to as those of Roosevelt. It IS a different time altogether. But Obama’s message got through during the election process. He has to USE his bully pulpit and eloquent words. Or none of us, especially Obama in 2012, will be able to live life as we’ve luxuriated in it since 1980.
http://crush.typepad.com (emasculation-blues)
http://apocalypse-blues.typepad.com/
Can we get Nico Pitney to ask a real question ?
NO !!
Love,
Dana Milbank.
((( CT )))
I’ll buy 3 Beers for whoever turned off the A/C … the reporters look dishevelled and tired …
Public option q.
I was a naive little thing working in the bowels of the theater complex at the time. No time to party, drink, whatever. . .
Jeebs
Obie
score already!!!!
Well, I noticed. . . but I’m not in that room.
Public option would lead to reduced coverage? How?
Public option to keep the insurance companies honest. If you take some of the profit motive out, you can get a better deal, which incentivizes the private sector to do better.
I gotcha, I showed up on campus 40 years ago straight from you know where with a hankerin to LIVE!
Reports of insurance companies making record profits and premiums are going up.
Love populism from Obama!
Great question on the public option — would you use it yourself?
Obama defends the public option to keep insurers honest; brings in record profits and premiums, so what’s their problem? Best answer of the night.
Constraint on insurance premiums-what about credit card APR,and Goldman bonuses?
Insurance making record profits
You are spot on with this, who(m)ever you are. He has a splendid gift and he needs to use it, often and well. Okay, and he needs to ditch Rahm Emanuel, but that’s quibbling.
Sincerely,
Who(m)ever I am
not holding my breath waiting for that to happen.
Is this Presser a result of the recent Bluedog conference with Obama…?
It was a dumb public option question, IMHO. Say the public option is a bare bones catastrophic plan competing with gold-plated private plans? So, how will that deny care to those in private plans?
Obama filibustering right now, probably better use of time than taking more questions like these.
LBJ got medicare cuz insurance companies didn’t want to deal with old people and their problems. Medicare 95% of it goes to pure health care, 5% overhead. Present healthcare 40% for overhead, advertising, over the top exec pay, paying to find loopholes to dump clients, extra money for docs and hospitals not to be against status quo.
Bam! Insurance companies right now are denying care, not doctors based on evidence. That’s not how it’s working right now. Right now doctors are forced to make decisions on the fee payment schedule.
I don’t know how you missed the speech notice. It has been linked to several interviews this week and announced on the networks, NPR, etc. Though I did think it was a speech and not a press conference.
I’m still having a hard time adjusting to a President who answers questions.
I think I’m suffering from an eight year hangover.
Dumb question, but allows him to get out good talking points on the public option.
I would be happy to abide by the same benefit package. Nice.
he had a list of who to ask . . .nothing new here.
Again this isn’t strictly true. There will be pushes to reduce repeat hospital visits for instance and this could well equate to reduced care, just not called a cut.
Dude, it’s not a speech, it’s a press conference.
Helen Thomas, now permanently on Obama shit list or is she not there?
40 years ago I was waiting to get back to the REAL WORLD!! But of course when I got there I showed up in Woodstock to Get back to the REAL WORLD!! And boy did I!!
what the hell just happened–who was the guy that spoke out of turn?
Nice question about Mayo clinic.
Those of us whose teevee’s are under wraps miss some of this. Our fault? Maybe. An email alert would’ve been a great heads up!
Yeah! I am so happy to hear that! That’s one of the biggest topics we should hit on!
Me too, came home Sept 3.
Why could Congress sign off on the abridgement of the Constitution with the Patriot Act in like 48 hours, destroying the basic intents of the Founding Fathers but not take care of the folks in America at this critical time?
Oh, yeah… terra-rists. Maybe we should frame the Healthcare discussion in terms of “if we don’t get healthcare, Al-Q will get us all”! It might be passed tomorrow…
no blogger questions tonight.
Insurers only want to insure those who’ll never need it-life or health.
Mayo reversed? Huh, news to me, gotta go check their blog…
Heh, I thought it was fancy new digs for the WH Press Corpse…? Already having issues with the A/C…? Was Halliburton the contractor…?
Too bad Gates got arrested for being in his home while black, but I think this is a dumb symbolic question.
in edit: I think the cop got pissed because Gates wanted the officer’s name and badge number. So cop thought he might get a complaint, so he decided to make it worse?? Or something…
hahahahaah
Hold the Mayo
Uh-oh, I call this last question from Chicago Lynn Sweet – a gotcha question. He’s stuck either way — biased cause he’s black, anti-police, or pro-police anti-black man.
OMG, he is coming down firmly on the side of the cops were stupid!
She doesn’t look convinced, but I really thought he would do a tightrope waLK between the sides.
Q10 what about the Harvard Prof, Gates, who was arrested outside his own home, because the police thought he was a burgler — except he’s a black professor — lots of red faces on white men for arrested a respected black man.
OMG This is so wonderful, this Skip Gates answer. Obama at his best.
Like he said himself, they will stop paying for unnecessary care. Not sure I’d call that a cut…
Is it just me–or does it seem like the pres corps is bored with having to talk about healthcare?
Where’s the Michael Jackson question???
Loving this! yay!
I think he was INSIDE!
Man no kidding; can you imagine Bush trying to field these questions?
Yeah well this guy dudn’t have to spend 5 months a year clearin’ Brush and stopping Cheney ( Who rumor has it is a Dick ) from eating Kittens !
Sept 3rd 69 when was that??
Purple Haze!!
Cambridge police acted stupidly — so says the Prez of the US. This is a good answer about racial profiling — Pat Buchanan will hate this, because it’s reverse affirmative action, right Pat?
I love that he answers questions head on. Police acted stupid, there’s a long history of police and racism. It’s just so refreshing to hear stuff like that.
here and here re Mayo.
She’s there, right on the front.
cleave those Hispanic voters completely away from Repubs!!! :-)
The day Ho died. I left, he gave up :)
YES YES YES YES YES YES YES
And we’re out.
Cool. Hope there’s a clip online later.
FunnyWheelieDiva
Now that was refreshing …
so now all the talking heads chatter turns to Skip Gates rather than health care.
Tweety heard Gates didn’t give up his ID fast enough.
She’s there.
Tweety has Dr Nancy on.
Yeah, I read Gates was already inside, showed his ID, and everything was settled, but then Gates wanted the policeman’s name and badge number.
Todd peddled ’sacrifice’ for patients junk. OK, Todd earns his F- for tonight.
Maybe corporattions who are making a killing should sacrifice a little.
Bored…? More like disgusted that they actually have to do their job…!
Ah, Steely Dan.
Oh man – he’s gonna take a huge amount of shit for saying that the Cambridge Police acted “stupidly”.
fucked up the whole press conference quite possibly. He’s entirely and absolutely correct about the profiling (follow me to court any goddamned day of the world) – but he could have stayed away from jumping smack into the middle of this one.
He was on CNN earlier and said he was inside and the cop came in without a warrant, the cop took his id’s walked out the front door and the professor followed him out onto the porch and then was promptly arrested because the prof. was asking the white cop for his name and badge number. But the professor said he would forgive him IF he apologized! But he has not as of yet…
Charlie Gibson is overpaid … even if he works for free !
what he didn’t say—didn’t push individual mandate. Good thing.
Would someone please give me/us a quick overview of how this went, what was boffo, what fell flat, etc.? I know, I know. If I want to know, watch it myself. Didn’t. Pbftttt!
Who defines unnecessary? Are elders being “unnecessarily” re-admitted into hospitals currently?
Rachel up
The day Ho died. I left, he gave up :) The Ghost!!
Yeah, America. Every other industrial nation has national health care, and we pay so much more per capita, but that ain’t gonna happen, reasonable health care as a citizen right, for this window of national opportunity. Sigh. And if we are lucky we will get second best. IF WE ARE VERY LUCKY.
BTW,
Anyone else notice how MSNBC was billing “Pregame coverage” for this presser?
I thought that, and another win/lose sports/battle thing I can’t remember right now, was unintentionally revealing.
It’s all about the game. The horserace.
Spit.
FWDiva
Yay, Rachel – love her intro – and she isn’t even finished w/ her adjectives!!!!
If Obama had been serious about overhauling healthcare single payer would never have been taken off the table as an option.
same goes for all the network anchors.
And it seems so much simpler than what they’re thinking about. Everyone pays, everyone covered.
Thanks re Helen. She accused Obama of being worse than Nixon in controlling press corps. She is on the list now.
You are right Spencer – perhaps I am too cynical. I really expected more weaseling.
i abhor that hack
Would describe Tweety every day.
Tuttle must be ecstatic!!!
Gates was already inside, showed two IDs and then asked the cop for his name and badge number. So cop got pissed and did something stupid. Why not tell the truth say the Cambridge cops were stupid.
Or was Gates packing heat? Took a swing at the cops with num-chucks? What?
Repeat hospital visits are not necessarily a good thing; a lot of them happen now because insurance companies cover hospital care (or pretend to, until they try to weasel out of it) but discourage providers from follow-up home care to prevent conditions that result in a quick repeat hospital visit. It’s one of those things that could be a “cut in care” if done wrong, or could be much smarter care (with better outcomes at less cost) if done right.
It depends on who makes the rules. And they can surely make them so that the “public option” can come up short. (I spent many many years trying to get claims through the MediCal hellish maze.)
It’s the middle of the day for the CT!
B-bu-but Cutie Couric got a makeover and sexy calves … /s
Yeah, but what are they gonna do, Congress and Pres, with all that lobby money? It would be dishonorable to betray those they let bribe them, after all. And how could they run next election without more bribe money? No money from us, the rabble.
A true reformer, Nader or Edwards or Kucinich or Greenwald, … it would matter to them that there were “stray” people not covered. Not rhetorically dusted under the rug, as idiots who don’t think they need it and make us pay for them in ER. That answer made me burn of Obama’s. One more opportunity to blame the victim. I think his NAACP speech had a whiff of that blaming the victim, too.
Sorry, I guess BO is on my list.
yep.
The corporations own the government and I don’t see that ever changing. Between the banksters and the health care industry there is what % of the GDP?
Marxist !
YES!! So glad you noticed too.
Heard Andrea Mitchel mention tune in afterward for “post-game analysis.”
Thought it was just her letting her pov slip out.
Then heard an announcer doing a promotional break say “pre-game analysis.”
Could not believe it.
Blue Pill and Red Pill? Fuck it, I knew I was in The Matrix. Thanks for the confirmation.
The US has relatively high rates of re-admission after discharge compared to other high income countries. The US has a pretty disheveled discharge system, and very bad coordination of care between inpatient and outpatient. It has also had problems with re-admits due to hurried discharges that are pretty much only done to come in under prospective pay caps for every admission. So I think it is a reasonable avenue for looking for problems and inefficient care.
Why is Rachel using Fineman and GIbbs (coming up). How about someone who knows the issue and isn’t in the club?
Aactually, yes. Very often, of course, it’s “necessary” because they were sent home/not admitted in the first place too soon, or with no follow-up, and bang, they have to come back a week later. Very common.
And yep, have you looked at Atul Gawande’s NYorker article? It depends where you are of course, but all too often the incentives for doctors, who know they’ll get paid w/ Medicare, mean treatment that isn’t really needed.
And for elders, especially – the most common unnecessary care is end-of-life care – all the desperate measures to keep a dying person alive, whre huge amounts are spent just to extend life, with tubes, in the hospital, when the patient could just as well go home and stay comfortable. That’s the biggie with elder care.
what’s your beverage of choice, sir/madam?
Personal story: I had a skin tag (little tiny skin tag) that was in my nose so it was…well….embarassing. Made an appt. w/ doctor.
Appt.#1: Saw PA who looked at said skin tag and referred me to a specialist!
Appt.#2: Saw specialist who confirmed skin tag and directed me to make appt. for removal.
Appt.#3: Finally had skin tag removed.
Left work 3 times, paid 3 co-pays, all for the tiniest of problems.
Oh, RevDeb, you don’t think she has complete control over her guest lists, do you? She works for MSNBC, so do they – they will have MSNBC regulars on, whether it’s Rachel or Keith or Ed or Tweety.
Feinman is an ass.
FWDiva
Hmmm… You offering me a drink, or accusing me of having had too much?
Did Obama say ‘jigger’? Isn’t that a faux pas?
The problem is that Congress won’t go for immediate single-payer. They rejected that out of hand months ago.
Oh, really? I’d think an HCAN staffer would pay attention to the numbers.
130 million — Enrollees in “public option” as devised by Jacob Hacker and sold by the “progressive” community.
9 million — Enrollees in “public option” as crafted in legislation, according to CBO scoring.
How are 9 million enrollees going to keep the insurance companies honest? Assuming they haven’t completely gamed the system — or rather, regamed it — by 2013?
He gave a big over-view of getting it done. Compared the hugh deficit he inherited with progress now + h.c. reform will be a factor toward reducing the deficit. His speech at the beginning best part of program; took a swipe at all the coverage the Congress gets. Gave some horror examples of folks suffering with no coverage, so why so important for families. Talked about regulation that will prevent denying coverage due to pre-existing problems and stopping coverage b/c someone is too sick to be covered or loses a job. Pretty broad picture for his argument. Then the questions….(Maybe this is close;))
Oh, no – it’s a convention, popular around here – when two people post the same comment at about the same time, it’s customary for one to offer the other a drink.
I think that came from real-life, custom some places, carried onto on-line.
I’m still on the mailing list for Obama and I’m also linked to his organization on Facebook. In addition, this blog and CNN and Yahoo all had the notification of this press conference since sometime Tuesday (fully 24 hours in advance).
The two e-newspapers I read had it on their front pages – Hartford (CT) Courant and Reading (PA) Eagle-Times.
Not sure what other methods of notification might’ve been available. Heck, I think Howard Stern even mentioned it during the show today (will have to look at the round-up).
Scientific evidence, I think, is the standard.
9 million isn’t nothing, and that’s only in the first few years of operation. This is about the long term.
The media can’t resist the fool’s gold. Watch this Gates stuff go viral.
Actually, the fact that Gibbs is coming on Rachel means, I think, that the WH realizes how influential and popular she is with the “far-left.” That is not a bad thing.
Oh, come on, Hugh. You and I both know the poor and elders overuse medical care constantly. Heck, I’d rather sit in the doctor’s office, read magazines, and fork over a co-pay than play shuffleboard any day of the week!
NOTE It’s those creeps from the Dartmouth study — the ones who look at variations in medical care without controlling for sickness in the population.
Actually some admissions are extended so that they will fall under Medicare. It is certainly true that a older patient discharged from the hospital may go into a home or nursing home situation where they receive insufficient help and are quickly back to be re-admitted. The second admission is in no way unnecessary. Without more resources dedicated to non-hospital care though, the need for such re-admissions will persist. Other countries indeed do have better systems for social support and outpatient care. I don’t see however the creation of this kind of social and medical extension of care in Obama’s proposals but maybe I missed it.
I went to a doctor who was scamming my insurance and kept talking in a complicated way about my payments. And he kept getting angrier and angrier at me for not catching the scam. I wasn’t catching on and he didn’t want to admit it cleanly. My math anxiety, I kept trying to make his rules match with my insurance. I backed away when the lightbulb finally went off.
I went to a dentist doubled over in pain and he explained that this is how we scam the insurance company. You pay extra but we get more back. No shame. Everybody does it.
Getting over that remote spectre insurance industry has been a national past time. But that ends up burning us all, too. And they started burning back. Not just their executive greed, but everyone looking to get over.
one lives in hope, but yes, the corporate owners of the world are always in charge.
After the broadcast, KOIN here in Portland claimed that the Presidents approval rating for heathcare reform was 33% for 59%(!) against, and the rest undecided.
WTF? What questions were asked?
You mean the fact that the Pres called the Camb police “stupid”?
Probably right. And altho’ some folks will cry “anti-cop,”, I don’t think that’s a bad thing.
If you mean the story itself, it already has. Pretty nearly every blog I read has covered it all week, and began making teevee news Mon.
And the thing that really pisses me off is all those joy rides they take in ambulances.
(I think Barbara Ehrenreich was first to notice that, many years ago.)
new thread’s been up for a while. Scarecrow
speakswrites.That’s because the naysayers have done a great job in getting the message out.
There was more play for the ‘waterloo’ comment by DeMint (or whomever it was) than for anything Obama has said on the topic. That’s because that’s what the media covered, multiple times a day, every day, since the comment was made.
Thanks for the impartiality, media hacks.
Yep. Single payer is the science-based solution. And according to Ezra Klein, all the cost saving scenarios are “speculative”.
We’re performing a giant experiment on the health of the American people for “speculative” reasons — and without their informed consent? Hardly ethical.
I do see that second admission as unnecessary. Where care is complete, and where single-payer systems exist, all the care gets delivered properly in the first admission, they don’t have to discharge because the ins. co., or medicare, will only cover so many days, and then, in those good systems, they have post-discharge support: nurses making visits, calls, early appts., taking time at discharge to be sure patient understands meds and what to take.
Patient is sent home with proper meds, instead of being given a script that patient can’t afford to fill, or forgets to fill, or has no one to send to get filled. Etc.
Now, in a very narrow sense, I see why you say the second admit is necessary. But to me, I look at it from a more holistic pov – that 2nd admit would never have happened if everything was in place and done right in the first place. To me, that means the 2nd admt was unnecessary.
Wow, Jason.
18,000 dying a year from today’s health care system. Let me take a minute and do the arithmetic, here, let me see, 2013 – 2009 is 4, 4 * 18,000, that would be 72,000…
Do you plan to explain to each of those 72,000 people that they died for the sake of what HCAN considers the long term?
Could you catch what he was talking about? I don’t think I heard that.
He got pretty amused at himself in the Gates’ re-enactment if he/Obama were trying to break into a house…either the WH or in Chicago.
Also tajanrusa, You either have a clinically defensible reason to admit someone or you don’t. My point is that whether we are talking regular re-admissions or end of life ones, lowering the frequency of these assumes a large external support network, which doesn’t exist now, and which I am not seeing talked about.
Such a network could catch problems before hospitalization was necessary, give follow up care to reduce early re-admissions, and through hospice deal with end of life in a more humane way. What I get from what I have heard so far is simply that doctors need to fix the problem better before discharge, even though shorter hospital stays are also being encouraged. And in any community there are always some physicians who abuse the system but I do not think it is that widespread. Remember in the Gowande article he took the most extreme case he could find.
“You think”? That’s a little vague, especially for an HCAN staffer. Can you please be more precise?
I’ve never been a great Obama fan, but the guy is a master politician. We saw that tonight, and it is one of the things we need. This presser won’t persuade the crazies, but I think it is helpful with a lot of people who may not have been following the issues closely. I actually admit to getting a dose of, I’m embarrassed to admit it – hope, from it myself.
I liked the reference to evidence-based medicine. I’ve worked in such a system. It is science-based, creating objective guidelines for care, but at the same time can allow for physicians taking individual circumstances into account in making treatment decisions. It’s one answer to the question of who decides what is necessary. There really are some objective standards that can be used, in contrast to the insurance company profit-based decision making that we have now.
That’s the judgment Obama made and that’s why it’s off the table. Was Obama right? Who knows? We know 2/3 of the American people have said they favor single payer in past polls. We know Obama did not offer single payer in the campaign. We know that Clinton deep-sixed single payer before losing with his complex alternative health care proposal in 1993.
No Democratic President has tried to pass a clean Medicare extension to everyone since Medicare was introduced in 1965. So who knows what a President could do with single payer if it was framed as an extension of Medicare? One thing we do know is that it would have been a helluva lot easier to communicate the idea of Medicare extension, than the complex plan of the Clintons, or the slightly less complex alternatives being proposed now. And simplicity followed by an all-out fight for something can really pick up a lot of support. I’m sorry Obama didn’t try it. I think the Congress would have come around.
I believe 2/3 siad they support public option; where is your support for that figure with single payer? Ante up dude.
Agreed. Change the eligibility rules for Medicare to include younger people and you instantly have a plan that could cover everyone, with the administrative structure already in place. People are familiar with Medicare and like it for the most part. It would be an easier sell, besides making sense.
Yeah, not sure it’s worth arguing with you. Maybe next time…
I believe sufficient time has elapsed since the gussied-up controversy over the use of the phrase to allow me to say that you are putting lipstick on a pig.
I am not aware that longer hospital stays to capture Medicare reimbursement is significant problem. If you have a link or reference, please post it. I will check back and will read anything you have.
As for your example of insufficient care after dishcarge, that is a problem of lack of rehabilitation, and home care in the US, which spends less on those two items, rather than more, per capita, than other high income countries. These are favorite whipping boys for the ‘waste fraud and abuse’ and ‘gold-plated care’ scam run by the GOP and corporate Democrats -as just seen in the CA budget crisis where the Gubernator accused the CA home health care industry of massive fraud based on zero evidence.
I am specifically talking about readmissios becasue of premature discharge and poor coordination of care between inpatient and outpatient. There is very good evidence this is big problem in the US. But, you are correct to be cautious, the devil is in the details.
Single payer plan. Making insurance “portable” between every American and the government, as in Medicare. That is so sensible besides cost saving, it would mean in this transient work society, where we likely will be changing and/or losing jobs more and more, all that bureaucracy would be saved if the employer is not in charge of choosing the provider. Some think it would save $350,000 million a year. Would pay for itself likely.
Why that would make eligible the “homeless” and as we all know the homeless do not exist as a recognizable and deserving class in America. It is America’s underclass. To be denied. Bill Clinton knew if he showed caring for them, even mentioned the word homeless, which I never heard from him (though he has written a book called Giving I heard, how ironic), it would excite the Repubs that their money would be offered up to socialism. The polls led Clinton. And the ambition to win the next election. Was it an underestimation of the American people that the majority has no empathy for the homeless. Maybe not. And Carter, look at him compulsively in a good way building homes for people. I don’t know his history working to help them as president, but he wants people to have homes now.
And we know where Reagan stood, he took away mental health and housing for them. Actually, he created the homeless class in doing that. And W didn’t give a d*mn about them. His family legacy of FDR New Deal-hating, mother Barbara’s dismissal that the Katrina victims would now be opportunistic and improve their lot, i.e., let them eat cake.
Altruism is dead in America. Empathy is dead. Declaration of Independence and dream of rights of all individuals hollowed out.
Do American people care about the torture program. Civilians dying in countries where we want oil. The homeless. Not so much, apparently. As long as they are hypnotized by lies of corporate media and the status quo gamesmen at the helm, they let our democracy keep on eroding. And cronyism not only on our upper levels but throughout the classes. Not a whole lot of empathy and stress causes even more narcissism. Or American karma?
Does Obama care about the homeless. Clearly no. Very clearly. How sad.
I liked Edwards for addressing the issue of homelessness as an important concern for America.
I keep this link handy for moments like these and challenges like yours. As for the public option poll figure that everyone cites as support for Obamacare, ask yourself honestly how many respondents actually had a blessed clue what they were being asked about; see also my comment and link to Robert Kuttner on the subject here.
When we can exhibit such collective,acquiescent indifference to the suffering of our OWN fellow citizens-how could one possibly expect empathy for strangers-especially if they are Middle Eastern or African.
Er, Jason?
Can you explain to me how “tak[ing] some of the profit motive out” will “incentivize the private sector to do even better”?
Last I checked, the private center was incentivized by profit; that’s what makes them the private sector.
In fact, if you’re an insurance company CEO, it’s your fiduciary responsbility to make a profit for your shareholders.
So what’s Obama proposing here?
It’s not worth it to you because you don’t have an answer.
Hugh @298 asks a very concrete policy question: Are elders being “unnecessarily” re-admitted into hospitals currently?
Your answer at @336 that “Scientific evidence, I think, is the standard.” Really? Which science? Computer Science? Metallurgy?
I’m not, actually, arguing with you, as you aver; I’m simply pointing out that you didn’t answer Hugh’s question in a manner that it’s reasonable to expect of a paid HCAN staffer, presumably an expert in the field. Maybe I should start saying HCAN’t? ;-)
So, I’ll repeat Hugh’s question: Are elders being “unnecessarily” re-admitted into hospitals currently?
Can you do some staffwork and get back to Hugh on this? Thanks.
*** Crickets *** from our HCAN staffer…. 72,000, 71,999, 71,998…
He may mean that the private insurers would be in price competition with the less expensive public system, and some of the effects that that would be likely to have would be (1) to force the private insurers to increase internal efficiency, (2) to reduce the degree of profit-taking, and (3) to reduce any unnecessary payments to providers, including rooting out fraud. Or, since I am not him, he might mean something totally different.
Hi Bmaz, thanks for the reply. I saw the figure today in an article I’m trying to retrieve now. The claim made was that older surveys, not current, because the polling organizations are supposedly polling public option and not single payer now, had consistently show between 60% and 2/3 support for single payer. The current figure for public option I’ve seen recently is 76% or 3/4, even higher than the previous 2/3 figure for single payer. I’ll continue to search for the reference and provide you another reply fairly soon. I’m sure my memory hasn’t failed me here. It’s usually very good on things like this. Numbers tend to stick in my head.
See my response to bmaz a smidge upthread.
http://www.nursingcenter.com/p…..tid=765774
Basically, if you can keep a patient in the hospital per the “3 midnight” rule, they are eligible for the extended care benefit once they leave. This is a rule that can place physicians in conflict with hospitals. The hospital gets the same payment per the DRG whether it is a one day or 3 day stay (my understanding) so they have an incentive to discharge the patient as soon as possible. The physician on the other hand may try to keep the patient in the hospital so that he/she can qualify for the benefit, i.e. access to skilled nursing which the physician feels is needed. Hope this helps.
Thanks for that reference. Here is a reference on relationship between readmission rates and quality of care. Given incentive in some cases for longer stay with Medicare, then it a complicated issue to resolve. As always in this business, the devil is in the details.
(added in edit: a good study will break down readmits into planned vs. unplanned, and look at stats by age and gender and diagnoses. I don’t have time to look into this right now in detail, but I would hope for US studies, any Medicare issues were taken into account)
OBJECTIVES: To help resolve the current controversy over the validity of early readmission as an indicator of the quality of care, the authors critically reviewed the literature using meta-analysis to derive summary estimates of effect and evaluate inter-study heterogeneity. METHODS: The authors selected reports meeting five criteria: (1) presentation of new data on medical-surgical hospitalization of adults; (2) measurement of outcome as a person-specific readmission; (3) readmission within
—-
“Readmission to the hospital within a few days or weeks of discharge is a common and costly occurrence. Depending on diagnosis, 5% to 30% of adult medical-surgical patients are readmitted within a month.” (in edit: I think this is range for US hospitals)
OH thank you, I agree Fineman was such an ass. I wrote to tell Rachel Maddow that, I am sure she cares what I think. But then he showed up on Matthew’s show and they were both asses. The two of them were whining there was no there there. I think what they were really upset with was they might have to pay a little more money, poor millionaire babies, they might have to part with a few bucks. Too bad Matthews didn’t have to pay for his week or two in the hospital out of his pocket a year ago or so. Wonder how he would like that. And then would Matthews and Fineman read Prof. Gate’s daughter’s Daily Beast article, then they could get their facts straight. http://www.thedailybeast.com/b…..mainpromo1
Some special characters messed up the past of the abstract. Here is the whole thing:
The association between the quality of inpatient care and early readmission: a meta-analysis of the evidence
Ashton CM, Del Junco DJ, Souchek J, Wray NP, Mansyur CL.
Medical Care. 1997 Oct;35(10):1044-59.
OBJECTIVES: To help resolve the current controversy over the validity of early readmission as an indicator of the quality of care, the authors critically reviewed the literature using meta-analysis to derive summary estimates of effect and evaluate inter-study heterogeneity. METHODS: The authors selected reports meeting five criteria: (1) presentation of new data on medical-surgical hospitalization of adults; (2) measurement of outcome as a person-specific readmission; (3) readmission within less than or equal to 31 days; (4) examination of some aspect of the process of inpatient care; (5) inclusion of a comparison group. One meta-analysis examined 13 comparisons of readmission rates after substandard versus normative care, another examined 9 comparisons of readmission rates after normative versus exceptional care, and the third examined all 22 comparisons together. Two authors applied inclusion criteria and extracted data on methods and findings. Two others classified studies on 11 methodological variables for the heterogeneity evaluation. RESULTS: The summary odds ratio for readmission after substandard care was 1.24 (0.99-1.57) relative to normative care; for readmission after normative care the summary odds ratio was 1.45 (0.90-2.33) relative to exceptional care. The individual odds ratios varied significantly (chi2, 21 df equal to 50.34, P equal to 0.0003). Most of the variance in study odds ratios could be explained by whether the study focused on the quality of patient care or the qualifications of patient care providers. The summary odds ratio for the 16 homogeneous comparisons focusing on the quality of patient care was 1.55 (1.25-1.92). CONCLUSIONS: Early readmission is significantly associated with the process of inpatient care. The risk of early readmission is increased by 55% when care is of relatively low quality, that is, substandard or normative instead of normative or exceptional.
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“Readmission to the hospital within a few days or weeks of discharge is a common and costly occurrence. Depending on diagnosis, 5% to 30% of adult medical-surgical patients are readmitted within a month.”
Thanks ralphbon. I have seen it and it reminded me that I got the 2/3 figure from the Robert Kuttner piece you cited above, which you linked to in one of your replies to the recent Seminal thread I began. So, thanks for that. Until I saw Kuttner’s article I was aware that polls had shown that a majority of Americans supported single payer, but, now I think that Kuttner’s analysis is right and that it is closer to 2/3. So, Bmaz, that’s my support for the 2/3, at least until a current survey on single payer is done.
This thread is getting really long and takes a while to reload so this will probably be my last comment. That looks like a good study but it is from 1997 so not exactly current. Quality of patient care can certainly impact likelihood of readmission. Length of stay might as in too early discharge but at the same time longer stays can result in complications and nosocomial factors.
My thought was more along the lines of a patient with a poorly controlled condition or who is not compliant with their treatment. Take such a patient with diabetes, COPD, or heart failure or even some combination of these. These people can show up repeatedly at a hospital, be worth admitting, need hospital level of care, get stabilized, get cut loose, and reappear in a few days or a few weeks. They can receive the best care in the world and it still won’t make much of a difference on whether they will need to be readmitted. I said to you in an earlier thread I believe that 1/3 of patients are non-compliant so this is a pretty significant issue, not just one or two on the margins.
ceo of mayo clinic on charlie rose totally dissing medicare. wow. he is kind of proposing a benign ice floe end of life cost saving solution for the aged. that is a bit chilling.l
and the elephant in the room not mentioned by media or Obama is tremendous profit gouging of health care industries. but never brought up in plans to make health care truly reformed.
these guys can’t serve 2 masters. so the corporatists are the shadow masters, and the spin is on to convince us as consumers they are doing their best for us. Where’s Ralph N. when you need him.