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Wednesday, November 18, 2009

HEALTHCARE - The need is optimal universal coverage with "optimality" based on some cost-benefit balance; and all else is smokescreen.

And in defining optimality there are subjective and objective goals. The subjective goal of Helmsley the top-gun boss at UnitedHealth is to optimize his ongoing cash flow, personally, and that is independent of what, objectively, is good for everyone else.

My guess is it was from the "achieving optimal answers for the public" perspective that Sixth District Congressional candidate Maureen Reed recently went to Washington to conference with Minnesota delegation people in both houses. Having decades of experience in cost-benefit healthcare management she doubtlessly shared her thinking there with lawmakers.

But anyone yammering in a Chicken Little, sky is falling, manner about rationing is full of -- deception and misdirection. That includes the likes of Glen Beck, Sean whats-his-name, and his darling guest, Michele Bachmann. They are full of it.

Now, in that context of the need for cogent cost-benefit balancing and not misleading us in the voting citizenry away from single-payer and public-option necessities by throwing an impairment to right-of-abortion-choice snake on the table to distract us -- in that context, how do you judge the usefulness and worth of this AP feed Strib carried about a week ago:

Health care issues: Controlling medical costs
By The Associated Press

Last update: November 12, 2009 - 8:22 AM

A look at key issues in the health care debate:

THE ISSUE: How can Americans control medical costs without it leading to rationing of health care?

THE POLITICS: There's broad agreement that health care costs are too high and that if left unchecked, they could bankrupt the government, not to mention businesses and families. The $2.5 trillion the United States spends each year should be enough to provide quality care for everybody — even if that means fewer tests and procedures. But politicians of all stripes are reluctant to confront the public with that message. That means any health care overhaul may wind up adding to costs, instead of curbing them.

WHAT IT MEANS: Cuts in Medicare and Medicaid payments to service providers may only check costs temporarily. Prevention programs can sometimes cost more than they save because of the additional services provided to large numbers of patients. The key to controlling costs seems to lie in changing the economic incentives for hospitals and doctors, so that they focus on keeping patients well and preventing serious complications among those who are in poor health. Such a cultural change could take a generation to bring about, and many experts believe that although Congress' health care bills take some steps in the right direction, they don't do nearly enough.

Ricardo Alonso-Zaldivar


It appears to me all the "news" outlet is saying is there will be cuts in Medicare and Medicaid, and there is nothing said about the camps with an interest - the public [last in attention by lawmakers and getting short shrift when polls consistently show a public desire for universal coverage and STRONG public option to keep things honest and quell profiteering], the insurance firms with their status quo and their likelihood of gaining more income as more money is put into the pot to cover more people and they under the passed house bill stand to take the lion's share of new money; the provider industry made up of administrators and caregivers, the latter getting short shrift at the hands of the former; and the pill makers working in concert with the pill pushers.

One Reed campaign person told me Reed's position is basically that the fundamental goal has to be preventative medicine and prompt cure, and not on extended treatment; as a matter of sensible policy. That implies reform aimed at prioritizing and rewarding patient-contact caregivers for preventative medicine and prompt cure; and penalizing any tendency toward extended treatment - which is only a euphemism for continually milking the cash cow as long as can be done without the cow running dry.

So, policy, Reed believes if I am not misstating things - where I expect a comment correcting me if so - Reed believes that the key plank in reform is to look at what within the provider community is to be rewarded or penalized in order to achieve an optimum. Beyond that, I am unaware of her detailed suggestions and await the Reed campaign website to flesh out this thinking. I likewise would enjoy knowing what the Clark position on things is, and I note her website is not helpful in learning this.

I think both Reed and Clark are excellent candidates, with either a vast improvement on the existing joke in congress from the Sixth District, and I encourage readers to contact both Clark and Reed and their campaign staffs to become as informed as possible, and to urge these two camps of people to populate the two campaign websites with things beyond, send money, volunteer, or sign up for periodic email which will be asking you to send money and volunteer. We, though mere citizens, deserve more. From each.

How else can we at this early stage, and later, favor one moderate DFL hopeful over the other? Neither is a Wellstone liberal for those who, like me, would want a Wellstone liberal in DC for the district - so between two basically identically inclined moderates, one with private sector history and expertise, the other with public sector legislative history and expertise, which to choose?

Without differentiation on the issues, for now, one is as good as the other, and either is a vast, vast, vast improvement over the polemic status quo diva we suffer.