From a very good piece in the NYTimes on lobbying:
One of the largest sources of campaign contributions to Senate Democrats during this year’s health care debate is a physician-owned hospital in one of the country’s poorest regions that has sought to soften measures that could choke its rapid growth.
According to the Times, the hospital has been quite successful in its efforts. And where is this powerful hospital with all the lobbying money located? Why in the metropolitan area of McAllen, Texas. McAllen, Texas? Hmmm…now where I have heard that name before?
Keep this in mind when you hear promises of Medicare savings from Washington.
Funny you should bring up physician owned hospitals:
http://www.slate.com/id/2223841/
That should read “Republican resistance to Medicare savings from Washington.”
Alex, the venality and stupidity of your country’s politicians have reached Latin American levels. Welcome to the club. And please start posting about its causes and why it is so difficult to stop the decline. Maybe you can introduce Mancur Olson’s gloomy prognosis to your readers.
the venality and stupidity of your country’s politicians have reached Latin American levels
Just curious: in what enlightened country has the the venality and stupidity of its politicians NOT reached Latin American levels?
Color me confused.
The Times article claims that the doctors from McAllen are trying to buy influence from the Democrats in order to prevent limitations on their financially successful business model. That makes sense: the Democrats are the ones in considerable power in both houses, with the and you usually don’t try to ask for favors from a group, in this case the Republicans, so heavily in the minority when discussing current legislation. Meanwhile, the article from The New Yorker article discusses this town as an example where Medicare costs are very high, as opposed to El Paso, where Medicare costs are lower. The difference seems to be entirely in over utilization, brought on by the business model used by the doctors.
What exactly does this have to do with the claims that there are legitimate savings to be realized from Medicare? Unless your entire point was a tired “politicians can be bought,” which is true but not particularly relevant, then I’m not sure what you are trying to say.
Carl Edman,
The link you provided absolutely does not say that. In fact, it says if we make McAllen more like the parts of the country that have properly aligned incentives, it will have better health and lower medical bills. Unless your claim is that there’s no chance for the Democrats to do this, posible but far from certain, I’m not sure what you’re talking about.
Guess who the congressman for this district is? The VERY liberal Solomon Ortiz. He’s represented this area for 22 years, so this debacle is all his. I blogged about the good congressman at http://txskirt.com. Can you tell I live in his district? Can you tell I’m not a fan?
An example of this adage, “Any attempt at regulation will be captured to protect the regulated parties”
Something to keep in mind next time conservatarians try to argue against public financing for elections.
The way the Democrats and the left in this country talk about health care reform reminds me so much of the Republicans during the run up to the Iraq War. These political sycophants will happily articulate any argument in any way possible, no matter how incorrect or sideways, in order to cast their party in a more attractive light.
To be sure, health care reform is absolutely needed. However, Alex is correct that these reform proposals are looking like nothing more than the usual political garbage as predicted by the public choice models. This idea that public choice issues simply dont apply to current policy proposals is absolutely reckless citizenship.
The amount of so called politically interested people who will happily regurgitate their parties line is distressing to say the least.
Unless your claim is that there’s no chance for the Democrats to do this, possible but far from certain, I’m not sure what you’re talking about.
There is no chance that the Democrats or the Republicans will do this. Even if an elected official were willing to institute cost cuts, they would be no more successful than insurance companies–whose patients don’t vote for their leadership–to decide where to cut and how much.
The point of the New Yorker article is that doctors are (quite properly) in control. The key is to reward doctors for more Mayo Clinic, patient-first types of care rather than McAllen, profit-maximization types of care.
Or, more to the point, create a mechanism to make the patient-first system more profitable. Such a system is far more likely to evolve from a portable, nationally available health plan.
I would think that the pure economists would be delighted to know that doctors in McAllen are acting in their own self interest.
Some of you sound like you did not read the McAllen article with any comprehension. Yes, its long. Yes, he’s biased. But he does drive some interesting observations. And, I think that he accidentally points to a deep issue.
His primary thesis is that doctors could improve outcomes by pooling their talent more effectively, and could reduce costs by reducing their focus on profits. Almost truisms there.
To me the interesting question is why? Why is it that we are seeing a rise in profit-driven doctors? As the article admits, this is not a phenomenon limited to McAllen. I’m not old enough to have known the system before the rise of the HMOs, but I think that when doctors had to start battling with insurers over process, something snapped. I’ve spoken at some length with a number of highly-respected doctors, and they volunteer the stress that they face dealing with insurance. (Including, or especially the feds.) I think that the big malpractice cases caused a shift towards isolationism just at the time that specialists, who ought to be collaborating the most, we rising.
I think that there is a societal fraying occurring, for which I blame the government-driven insurance & tort systems to a great degree, and that doctoring-for-profit is the effect.
Whoa, my mistake. I misread what you wrote, Right Wing-nut. My apologies.
“The hospital, which is in Edinburg, adjacent to McAllen, is working both sides of the aisle.”
ARE YOU STUPID? DO YOU THINK THIS CHANGES THE POINT OF ALEX’S POST WHATSOEVER?
john pertz,
By “we,” I mean the citizens of U.S., or more specifically, the voters.
“Do you know how pissed off seniors and the AMA would be if there were a NHS style system that told Medicare, Medicaid, and Obamacaid NO on certain procedures?”
Yes, I do. But it sounds like you are assuming this process will be entirely arbitrary and random. Congress can certainly be cowardly, but that’s why we need an independent body that can insulate them from tough decisions to some degree.
I also think you underestimate the degree to which people rely on their doctors for advice. If we can change the mindset, even slightly, that more care is necessarily better care, people will probably be less likely to protest any denial of care. Hell, if the system is changed so that the treatments aren’t ordered unless they are necessary, they won’t know they are allegedly being screwed over.
My wife is from the Rio Grande Valley, close to McAllen, and you have no idea just how truly terrible the care provided in the Valley is. We are talking Canada-style waits. My mother-in-law once checked in and waited several hours for them to tell her that the results weren’t in yet. Seems they could have done that immediately upon her getting there. Oftentimes the doctor won’t even be there yet, and you will have to wait for him to arrive, even though you made an appointment. They overbook 2-3x what they can actually see, making people leave in frustration after a few hours. Recently, in Brownsville, an elderly gentleman, after learning his doctor wasn’t there, pulled out a gun and shot himself in the head. My theory is that he couldn’t take being treated like cattle any longer. This is a place where they had no idea what to do with my wife’s insurance because they only deal with Medicare and Medicaid. The Valley also has extremely high levels of fraud. When covering health care in the Valley, people need to talk to the customers, not the doctors.
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