manufactured anger

[BigSky]

It is getting harder and harder to hear what is being said over the spittle. I think though when you look back at historic legislation there has always been this sort of blind rage that is ginned up and fanned. This sort of rage was used to bash the unions from the turn of the last century to today. On the other side of the coin from the rage is the cheering e.g for anti-sedition laws, the Patriot Act. John Rockefeller Jr. was burned in effigy for proposing the Grand Tetons National Park. I think this rage will be just as hard to understand 100 years from now.

It will be well understood.  The majority of people in the country are against this but yet this Administration wants to trample right over the people on it   

Teddy Roosevelt was driven out of the Republican Party. To this day they'll tell you Franklin Roosevelt was a communist. Civil rights legislation, the clean air act, water quality legislation - it all was said to be a threat to the world as we know it.

Medicare was said to mark the end of freedom in America. It has always been crazy talk. Now is no different.

The worry is when people believe this talk and then violently act on it. We're only six months in, the spittle will get thicker. This is a strain of America that will always be and has always been with us. We're just entering a period when it's very close to the surface.

Franklin Roosevelt was one of the worst if not the worst presidents in history. 

He set in motion the gigantic government bureaucracy we unfortunately live with today.   In the process he hurt this Republic beyond measure and its effects are still felt.
Among his worst Constitutional violations was his putting of Germans and Japanese in Concentration Camps.

[Bill Peckham]

It is getting harder and harder to hear what is being said over the spittle. I think though when you look back at historic legislation there has always been this sort of blind rage that is ginned up and fanned. This sort of rage was used to bash the unions from the turn of the last century to today. On the other side of the coin from the rage is the cheering e.g for anti-sedition laws, the Patriot Act. John Rockefeller Jr. was burned in effigy for proposing the Grand Tetons National Park. I think this rage will be just as hard to understand 100 years from now.

It will be well understood.  The majority of people in the country are against this but yet this Administration wants to trample right over the people on it   

Teddy Roosevelt was driven out of the Republican Party. To this day they'll tell you Franklin Roosevelt was a communist. Civil rights legislation, the clean air act, water quality legislation - it all was said to be a threat to the world as we know it.

Medicare was said to mark the end of freedom in America. It has always been crazy talk. Now is no different.

The worry is when people believe this talk and then violently act on it. We're only six months in, the spittle will get thicker. This is a strain of America that will always be and has always been with us. We're just entering a period when it's very close to the surface.

Franklin Roosevelt was one of the worst if not the worst presidents in history. 

He set in motion the gigantic government bureaucracy we unfortunately live with today.   In the process he hurt this Republic beyond measure and its effects are still felt.
Among his worst Constitutional violations was his putting of Germans and Japanese in Concentration Camps.

Yes. For example.

[Wenchie58]

People want reform but not this reform when it comes down that is has to be rammed through without the People knowing whats in it and being able to debate it at length.

Could we at least have more time to look and it than he gave to getting a dog for his family?  Or is that too much to ask.


If he wants to fix something why not fix medicare instead of wanting to embezzle money from medicare?

Dems control Congress and could easily remove the cap on wages (106,800) that are taxed for medicare. Tax all of those multimillion dollar wages of CEO's

OMG!  I agree with BigSky  <THUD>   

[BigSky]

Example?

Pure and simple ,the expanded role government has since taken on from the "New Deal". 

Which I might add prolonged the depression and in fact when the Supreme Court struck down several key parts of the New Deal he turned around and violated the Spirit and Integrity  of the Constitution when he pushed to pack the SC to get a court that would rubber stamp what he wanted even if it was in violation of our Constitution.  He openly and deliberately tried to destroy our system of Separation of Powers and violate and destroy the Supreme Courts judicial independence.

[Jie]

Without the "New Deal", there was probably no medicare to cover dialysis, and a lot of ESRD patients were probably ending up death without the financial means to do dialysis.

[BigSky]

Dialysis wasnt covered by Medicare until 1973.




Just a little blast from the very past, well last August anyway.

In a town hall meeting in Virginia Obama  said the following about healthcare.

"People say, 'Well, you have this great health care plan, but how are you going to pass it? You know, it failed in '93,' And what I've said is, I'm going to have all the negotiations around a big table. We'll have doctors and nurses and hospital administrators. Insurance companies, drug companies — they'll get a seat at the table, they just won't be able to buy every chair. But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think is what is going to allow people to stay involved in this process."


My my my how he forgets things.

[Bill Peckham]

Dialysis wasnt covered by Medicare until 1973.




Just a little blast from the very past, well last August anyway.

In a town hall meeting in Virginia Obama  said the following about healthcare.

"People say, 'Well, you have this great health care plan, but how are you going to pass it? You know, it failed in '93,' And what I've said is, I'm going to have all the negotiations around a big table. We'll have doctors and nurses and hospital administrators. Insurance companies, drug companies — they'll get a seat at the table, they just won't be able to buy every chair. But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think is what is going to allow people to stay involved in this process."

My my my how he forgets things.

But if Medicare wasn't passed in 1964 there wouldn't have been a program to cover ESRD in 1973.

The health insurance reform bills have been going through the committee process - which is on C-SPAN. The big table approach (kinda like Clinton's in '93/'94) doesn't get actual legislation produced. There is a health insurance reform bill in the House http://www.opencongress.org/bill/111-h3200/text which should go to the floor in September. And eventually there will be a bill brought to the Senate floor. Both of those processes will unfold on C-SPAN.

Not that anyone watches C-SPAN.

[BigSky]

Except that is not what Obama said.

[Bill Peckham]

Except that is not what Obama said.

Stop the presses - a politician isn't following every detail of what he said during a campaign.

The election was less than a year ago. Healthcare reform was a major topic. The House bill and what sounds to be coming out of Senate Finance is pretty much what Obama proposed during the campaign. He was elected to get reform through and enacted into law. As others have said supposedly all politicians of both parties are in favor of fixing/reforming/improving healthcare - no President since LBJ has succeeded. What stopped the Rs from 2001 to 2007?

I think the voters who supported Obama want legislation introduced and passed. It looks like legislation will come to a vote in both Houses of Congress; that is more than anyone else has been able to accomplish. I have a feeling this is going to be like the Stimulus bill, the Sotomayor confirmation, cash for clunkers - there is all this fury on the right and in the end two thirds of the country's Senator's vote for passage and the angry 30% gets another grievance to add to their growing list of ways the whole world is now wrecked.

The only question is can the Democrats whip 60 or more votes in the Senate or does the bill just go through reconciliation. They'll get a bill to the floor and if Kennedy and Byrd make dramatic appearances you could see 66 to 70 votes in favor. Look what happened last year in the Senate on HR6331 which passed with a veto proof majority because, it is said, Kennedy made a dramatic entrance.

Back to the seeming point of this thread - after the bill is passed and signed into law the angry 30% will still be angry. I don't think there is a single thing anyone can do about it. Electorally they're impotent which means they might devolve into something like code pink and make asses of themselves at hearings, speeches and town halls  or ... ?  What do you think will be next for the angry 30% after they loose this legislative battle?

[BigSky]

Hmm but yet who was the politician who touted "change".


As to your fictitious 30% claim, in reality more people are against this than are for it.

Its very clear from the town hall meetings that the people in Congress are not listening to the concerns of the People.

One example, In our State 58% opposed the Sotomayor confirmation yet the two asshats we have in Congress who are suppose to Represent the people of this State (well at least they claim that is their job) voted for her to be confirmed.  They chose to ignore the will of the people in this State and follow like lemmings what the National Party told them to do.


I will admit bill, you might be right that it will go like the stimulus bill, sotomayor confirmation or the cash for clunkers.

Only 37% of the People supported the stimulus bill-----Rasmussen

Only 47% of the People supported Sotomayor confirmation----CNN

Only 35% of the People supported the cash for clunkers program.------Rasmussen

Hmm and according to the WSJ only 36% said  Obamas health care plan was a good idea.


Seems to be quit the pattern of lack of support by the people.

[paul.karen]

Dems are the ones who originally held up the bill from passing.  The blue dogs.
But the obama administration is at odds with each other yet again.
Boxer and pelosi say one thing Obama says another ect ect ect.
Remember Pelosi saying we will vote for this before the summer recess over and over and over. 
Yes they wanted to push this healthcare reform through the house and senate yet again UNREAD just to pass it and then let the chips fall where they may.
The people even many DEMS are against this fast approach.  I am glad not everyone just follows Obama lock step.
Now they want to raise the debt ceiling from if i recall 13.7 TRILLION to a much higher number.  This from tim giether on friday at the end of the day.

Do people who support all of obamas agenda not understand this is not free money.  It has to be paid back and as it is we will be paying this money back for the next twenty years with interest. Not to mention we still have to live and survive before them 20 years are up.

The angry 30% you say bill?

Why when the dems do a rally it is a community event when repubs do it it is an angry mob.  This is laughable.  Short term memory for so many democrats. It was ok to bash Bush but dont tread on Oboma for it is a sin and he is taking names making threats and sending out the unions to bully people.  This is the TRUE democratic way and sadly enough Obama supports these tactics instead of trying to calm the fire.
Remember the conventions.  The republicans had nice rallied opposing obama peaceful protests if you will.
Then when the democrats went to the Republican convention they lit fires threatened people (regular people like you and me with there children at there sides) saying you better vote obama.  They smashed windows caused general havoc ect ect. 
Yet dems are community leaders and civil while republicans are mobs.

And to say only 30% are against obama care just shows how one sided some truly are. Read any poll other then the leftsided polls your reading and see the real numbers.

Lets keep facts facts.  The ONLY reasn this bil hasnt passed is due to the BLUEDOG Democrats not any other reason.  Pelosi and reid had fits of rage due to these democrats not following there agenda.
But obama and pelosi are doing there best to blame MOBS of angry republicans for the failure of this bill passing UNREAD and before summer recess.  They did there best to keep this out of the hands of american people to debate.

[Bill Peckham]

The reason they wanted to get bills out of committee before the Aug recess was so you could read them. Pelosi is in charge of the House - their bill is sitting right there on the internet for anyone to read. If you want to be disappointed with someone how about Baucus who didn't get a bill out of the Senate Finance Committee. This is the legislative process. I think for a lot of people this is the first time they have really watched as a major bill comes to a vote.

If you want to use polling to support your position please feel free (but I seem to remember oh about ten months ago and for eight years before that polling was suppose to be meaningless) but please link to the full poll so we can see how the question was asked. The result of opinion surveys depends entirely on how you ask the question - if you ask:
q49Would you favor or oppose the government offering everyone a government administered health insurance plan -- something like the Medicare coverage that people 65 and older get -- that would compete with private health insurance plans?" 2/3 say Yes.
http://www.cbsnews.com/htdocs/pdf/ju...th_care-AM.pdf
Two thirds is a substantial majority in American Politics.

The other thing that I would remind you of is that in our system it is not enough to be against policy or a political party, you also have to have a politically viable party that could get into office and enact different policies. Look at the polling on the Republican Party right now:
q38 Regardless of how you usually vote, who do you think has better ideas about reforming the health care system -- Barack Obama, or the Republicans in Congress?
                       Total    Rep    Dem    Ind
Barack Obama      55      27      81      48
Republicans         26      52      10      26
Both (vol.)            1       2        2        1
Neither (vol.)        7        9        2       9
DK/NA                11      10       5      16

27% of Republicans think Obama would do a better job (FYI: in polling (vol) means the respondent offered an answer that was not given - they volunteered either both or neither)

[paul.karen]

I dont think i ever said polls were meaningless, with that said i dont rely on them and i agree it is all about how they are worded. 
But again i say that it is the BLUEDOG DEMS that have held up any attempt to pass a bill.  Not mad mobs, not astroturf not republicans.  If not for your own party this bill would have been passed like the others without anyone reading them.


You do realize it is the federal government who runs medicare and social security.  And both these operations are gonna be gone in the next few years gone as in broke.  You being a big suppoerter of Obama would you agree or disagree with this assertion.  Im just curious.

[smilindon]

  If you watched arlen specter on tv this a.m. at his town hall mtg. in Penn. and if you really listened and thought about his responses to the questions you will know that he is one slick politician and unfortunetly will bam bozzle the people of penn again. One good example of his slickness was his answer to the question about the health care plan providing  tax payer money for abortion. His answer (which went unchallenged) "You will be given the option to have your insurance coverage that will not allow payment for abortion and Mabel or Sue or whoever may elect to have abortion coverage but will be charged extra premium for it........................ EXCUSE MEEE. Isnt't the taxpayer paying for this plan  Period? Several other questions were answered with "very good question ,I will take that back to D.C. with me. And his answer for term limits? "Well don't the voters have that right now?" If so why did the senate put in term limits for the pres? The answer is that you can fool some of the people all the time: ergo Penn re-electing specter again and again.

[Bill Peckham]

You do realize it is the federal government who runs medicare and social security.  And both these operations are gonna be gone in the next few years gone as in broke.  You being a big suppoerter of Obama would you agree or disagree with this assertion.  Im just curious.

I will categorically assert that this is false. I am prepared to say without any hedging that Social Security and Medicare are in no danger of being "gone in the next few years".

But again i say that it is the BLUEDOG DEMS that have held up any attempt to pass a bill.  Not mad mobs, not astroturf not republicans.  If not for your own party this bill would have been passed like the others without anyone reading them.

I think you are misreading the politics. The Blue Dog coalition is about 50 members strong in the HOUSE OF REPRESENTATIVES. Right now the US House of Representatives has 79 more people in the Democratic caucus compared to the Republican caucus. Do you see the flaw in your analysis?

All the action is in the Senate and again the Senate is an emotional body and they can be swayed if Byrd and Kennedy make appearances. Watch the Senate, the Blue Dogs in the House are not much of a factor. The Blue Dogs can vote in mass against for their own electoral reasons and no one will care.

[paul.karen]

Correct  thx for pointing out that the democrats have the MAJORITY not the republicans.  Thus they should be able to pass ANY BILL THEY CHOOSE to without much hassle.  Thus you can blame whoever you want to the fact is the bluedogs are the MAIN factor for the healthcare bill not being passed already.

And WOW you think Social security and medicare are doing fine and in no danger. I think you are the only person i have heard say this.  Even Obama as well as almost every democrat and republican i have heard disagrees with you.
You can also put the US postal service in the group of Government run companies about to go bankrupt if not out of business.
But i ques you will say the Post Offices are doing just fine and are also in no danger.

And our very unofficial poll here seems to disagree along with the majority of Americans with obamacare.  As well as the fact the people who are not happy are just ordinary people like you and me.

[BigSky]

If you want to use polling to support your position please feel free (but I seem to remember oh about ten months ago and for eight years before that polling was suppose to be meaningless) but please link to the full poll so we can see how the question was asked. The result of opinion surveys depends entirely on how you ask the question - if you ask:
q49Would you favor or oppose the government offering everyone a government administered health insurance plan -- something like the Medicare coverage that people 65 and older get -- that would compete with private health insurance plans?" 2/3 say Yes.
http://www.cbsnews.com/htdocs/pdf/ju...th_care-AM.pdf
Two thirds is a substantial majority in American Politics.

Two thirds is a substantial majority, but that question is not indicate any support of Obamas plan.



How the question is asked?  You are grasping at straws. Its a straight forward question when they ask if its a good idea or bad idea.


As of a couple days ago as per Rasmussen, only 32% favor a single payer system and  57% oppose it.


This thing of passing the bill an they letting the chips fall where they may and their claim they can come back and address stuff is nothing but bull.  Government rarely ever goes back and does the right thing and when it does it often takes decades to do it.

If they cannot do the job right the first time, then shouldnt be doing anything.

[Zach]

... Government rarely ever goes back and does the right thing and when it does it often takes decades to do it...

Passed:
1988: The Medicare Catastrophic Coverage Act of 1988, the largest expansion of the program since the enactment of Medicare, included an outpatient prescription drug benefit and a cap on beneficiaries' out-of-pocket expenses, and expanded hospital and skilled nursing facility benefits. Medicaid began coverage of Medicare premiums and cost-sharing for Medicare beneficiaries with incomes below 100% of the federal poverty level, known as Qualified Medicare Beneficiaries (QMB). The U.S. Bipartisan Commission on Comprehensive Health Care (which became known as "Pepper" Commission after the late Congressman Claude Pepper of Florida) was established to assess the feasibility of a long-term care benefit under Medicare.

Repealed:
1989: The Medicare Catastrophic Coverage Repeal Act of 1989 retracted the major provisions of the 1988 Medicare Catastrophic Coverage Act, including both the outpatient drug benefit and the out-of-pocket limit. QMB benefits were retained.

Lots more information about Medicare legislation at:
http://www.kff.org/medicare/timeline/pf_entire.htm

[BigSky]

That would be one of those "rare" occasions I mentioned.

[Bill Peckham]

That would be one of those "rare" occasions I mentioned.

Most major legislation is revisited and "fixed".  The civil rights acts of the 50s were strengthened in the 60s. All the clean air and water acts didn't get us to where we needed to be when they were first passed but over the years they've been strengthened. Welfare reform in the '90s had to be revisited. Medicare is revisited yearly. The legislative process is never finished.

For all that's been talked about here there are three parts to the current discussion. The core of the health insurance reform bills are these eight points that will go a long way towards ending the ponzi scheme insurance companies currently run.

The White House lays it out http://www.whitehouse.gov/health-insurance-consumer-protections/:

• No Discrimination for Pre-Existing Conditions
  Insurance companies will be prohibited from refusing you coverage because of your medical history.
• No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays
  Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
• No Cost-Sharing for Preventive Care
  Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
• No Dropping of Coverage for Seriously Ill
  Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
• No Gender Discrimination
  Insurance companies will be prohibited from charging you more because of your gender.
• No Annual or Lifetime Caps on Coverage
  Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
• Extended Coverage for Young Adults
  Children would continue to be eligible for family coverage through the age of 26.
• Guaranteed Insurance Renewal
  Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won’t be allowed to refuse renewal because someone became sick.

That would be a lot of very needed reform. That's the insurance reform piece.

Then there is the question of the 40+ million people without insurance.

And third there is the question of how to decrease Medicare/healthcare spending.

The goal is to do all three but I think most people acknowledge that the legislation is not going to be perfect but good legislation will be good enough. Then we'll see legislation building on what is passed.

I think you summed up the Republican point of view exactly right "If they cannot do the job right the first time, then shouldnt be doing anything."

This is why nothing has been done. It's why Kennedy didn't compromise in 1972 with the Nixon administration. It's why insurance companies have been allowed to mine human misery for profits. The goal of immaculate legislation is nothing more than a way to continue without change.

I think, and an electoral majority of the country thinks, keeping things the same is not an acceptable strategy. We had an election about this - the system is working the way it is suppose to work. The legislation doesn't have to be perfect, it only has to be better. ANd that is a very low bar when we're talking about the US  system of healthcare finance and access.

[tyefly]

 I for one have private insurance  (Kaiser ) and I am not on dialysis yet…. I do worry about losing my insurance, because my insurance company may find some way to drop our plan…. We are a small business and our plan in thru our business…… If I was to lose my insurance now I may have to sell my assets, possible get a divorce and make myself broke... Scares me to death…..  And with the Discrimination for pre-existing conditions I would not be able to get other private insurance… I have not cost my insurance company much money…. Yet…..!  But I am sure I will once I go on dialysis or get a transplant…… I don’t like rationing but that is the real world...  I think there is a fine line between cutting cost and rationing... I know that my insurance company rations  ( or whatever you want to call it )  all the time… they set standards for certain things and if you don’t meet those standards well  you don’t  or won’t receive the treatment or medication.. even if you feel that you need something.     I do not follow politics a lot as it can be very confusing for a reason….   What Bill wrote here, laying out some of the health insurance consumer protections to me is exactly what I would need and like to see….   I believe we do need to do something.   I don’t like big gov and there certainly has always been problems but there have been many benefits from government actions that have been very positive.  We often over look those….  Change is scary but without change we will never move in another direction…..  I certainly hope that we do move into this direction with the health insurance consumer protections portion of the bill…..   

[BigSky]

Nothing is "laid" out on that page bill,

That is nothing more than vague statements of which no solid details.  Another one of those trust me, I am with the government and know better deals.

We all see how well the government is running the Post Office, how well they are running SS/Medicare.  The only thing they are doing is running them into the ground.  They are failed business models and the government refuses to act accordingly.

Its pretty clear by the lack of support for these 5 various bills in Congress that the people do not think its "good enough" as you put it.


Otherwise if it was there would be no need to try to ram this through in 3 weeks, no need for top democrats to lie about those who are at these town hall meetings and no need for the President to falsly claim that AARP was behind his bill when it has not come out for any bill yet.


I might add that the no cost measure for preventive care statement is a joke.  That insurance has to fully cover all such costs?   This will send premiums through the roof.


Its like saying that your car insurance should cover preventive care like oil changes.

[Bill Peckham]

Really the post office? It's been around two hundred years. Because of reliable postal service our economy has reaped huge benefits over the CENTURIES. And yes we are witnessing an age of email and online bill payer and skype and everything else that is the reason I haven't bought stamps in a long time. Of course the post office is going to have to change. They have far less volume, most if it is business bulk mail, closing on Saturdays or Wednesdays is probably a smart way to begin the process of scaling back our mail delivery infrastructure. Is that the post office's fault or should they feel like they failed?

I don't think so.

It is interesting though to look at postal services and think about healthcare. The post office provides a range of mail delivery services. They do not however do anything you might want as far as shipping, etc. Right? They have a menu of services. We don't say shipping services are rationed. It's an opportunity for private companies to provide services beyond what the government provides. Fed Ex isn't going to deliver to you a birthday card from your great Aunt for less than a buck, and the postal service doesn't do all UPS and the rest do. Why is that a problem?

It's a good example of a public private system that provides the public with a diverse range of services. Home delivery for a nominal per letter fee and if you want to get a package to Hong Kong in 24 hours you can do that through any number of private carriers.

And as far as the politics - most people I know like their local post office and mail carrier. The post office is important to people even while we've stopped relying on them for the majority of our communication.

[BigSky]

Really the post office? It's been around two hundred years. Because of reliable postal service our economy has reaped huge benefits over the CENTURIES. And yes we are witnessing an age of email and online bill payer and skype and everything else that is the reason I haven't bought stamps in a long time. Of course the post office is going to have to change. They have far less volume, most if it is business bulk mail, closing on Saturdays or Wednesdays is probably a smart way to begin the process of scaling back our mail delivery infrastructure. Is that the post office's fault or should they feel like they failed?

I don't think so.

I am not sure length of time is a bragging point for them.  In that whole time they have a legally protected monopoly on mail delivery.

Even with having this monopoly they routinely lose money.

Over 5.1 billion in 2007 and 2.8 billion in 2008.    Every few years they are having such losses.

They are a failed government business model.  They refuse to change.  Instead of change they just try to charge more to make up the bulk of the money they spend in excess.

Which you might ask yourself this question bill.  If the Post Office  has been around for 200 years, why are they renting locations instead of owning them?  Everyone knows owning is cheaper than renting, especially long term.



 

It is interesting though to look at postal services and think about healthcare. The post office provides a range of mail delivery services. They do not however do anything you might want as far as shipping, etc. Right? They have a menu of services. We don't say shipping services are rationed. It's an opportunity for private companies to provide services beyond what the government provides. Fed Ex isn't going to deliver to you a birthday card from your great Aunt for less than a buck, and the postal service doesn't do all UPS and the rest do. Why is that a problem?

The reason Fed Ex and UPS do not deliver that birthday card for less than a buck is because they are prohibited by the legal monopoly that the Postal Service has on mail.  Hence  you want to mail that card through Fed Ex or UPS you have to mail it at box shipping rates or by express mail.

[Hemodoc]

Dear Tyefly,  all the time that I worked at Kaiser, I never saw rationing.  I was not prohibited from doing what was right for my patients.  Sure, there were roadblocks occassionally but any system you must learn how to get around them and play the system.  In fact, you have access to both NxStage and in center nocturnal dialysis.  Kaiser is certainly not a perfect system, but it is the system that let me dialyze at an FMC unit with an exclusive agreement with Kaiser that achieved a 7% mortality rate in 2008.

I understand the issues of losing insurance which hopefully you will never experience.  Most of what you need at Kaiser is to find a doctor who will put up with the administrations harranging and simply do what is right.  I simply developed thick skin and plodded on trying to do what was right for all of my patients to the best of my ability.  In a system with out right rationing, I would never have been able to do what I did.  Kaiser is quite sly to not have prior approval for most tests or treatments done with in the system but only after the fact discusses with the doctor how they compare to their colleagues.  It is a very powerful tool, but nevertheless, it is after the fact not before.

So, I do take issue with saying that Kaiser rations care.  I feel confident that at the present time, there are no treatments that I could not get somewhere with in my system.  I have seen that happen with many of my patients to know it is true.  In fact, here in California, there are state laws placing the HMO at great risk for denying state of the art care.  If it is not done within Kaiser, then by law, Kaiser must contract to a source outside to obtain the needed treatments or testing.

The only area that gets gray are those that are deemed experimental.  Kaiser has a very conservative process in adopting new technologies.  Sometimes that is for good and others in my opinion not.  Once again, I really can't agree with the statement that Kaiser rations care.  There are many Kaiser guidelines which many times are exceeded on the judgement of the treating physician.  As I have stated before, it is my fear in the current house bill that as a physician, if I was still practicing, I don't believe that I could have delivered the same amount of care that I have because it appears to me that my authority to supercede the guidelines would be eliminated.  If I am not correct on this assertion, then let me stand corrected.