Not forgetting it. 
It will always amuse me that even Taiwan, that would teach us a thing or two about fighting against communism, decided recently that it was better that all citizens had access and a safety net against health care cost bankruptcies.
And at the same time I can’t imagine Jon Stewart wasting time and airspace on somebody with a book about Nostradamus predicting the Mayans would come back in 2012 and raise Elvis and Michael Jackson from the dead, while King- oh yeah, he’d talk to him for the entire hour then take calls from a Tulsa woman who wants to know if Edgar Cayce is Jesus or just one of his elves.
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Ah, you’re so uninformed. If only you watched The Daily Show you’d have oddles of counter-examples.
You have watched The Daily Show, right? I mean you’re in here commenting on it and all.
FWIW, the VA (Department of Veterans Affairs) and “military” (Department of Defense) are both cabinet-level departments with their own separate budgets. The VA is not engaged in keeping soldiers healthy (it is involved in keeping ex-soldiers healthy), nor is it part of what we usually think of as military spending. In FY 2009, the budget for the DoD was about $650B, and the VA about $33B.
ETA: The VA also runs home loans and other services and maintains veterans’ cemetaries out of that $33B.
ETAA: The VA also offers benefits for the families of vets, including, presumably, women.
Don’t kid yourself–a standard rightie tactic is to patronize the leftie (poor sad delusional soul) while position themselves as martyrs (it’s us who are persecuted and demonized!).
That he likens Stewart to Limbaugh–when they’re polar opposites not only in beliefs but in style, temperament, and sensibility–shows either a flagrant dishonesty or an epic delusional quality.
Man, is anyone watching at the moment? Almost better than last night.
It was weird. Shows like this should be an hour long.
Wow. If many of those on your side of the aisle think this, it’s no wonder they’re acting the way they are. That really must be a frightening thought to have. Still, I must admit that I’m unconvinced so far by the arguments used to show why the U.S. would be ripe for this kind of transformation when it hasn’t happened anywhere else systems even more “socialistic” are used.
But that’s beside the point (I was making). I saw the segment (part of it) this evening, and I enjoyed it. Still, I pretty much know/can imagine what those skewered in the segment would say in reaction, and I’m sure they’d mean every word.
Still doesn’t make it any less funny, tho’.
Addendum: Hmm. From Bill O’Reilly’s comments, I may have been wrong with my guess mentioned above. I was thinking that he/they would concentrate more on context as in “Bush was fighting a good, just, and necessary war while Obama is tinkering with something that’s not broken and leading us to inevitable ruin,” not on context as in “surrounding parts of the segment.”
I’m pretty much a moderate, but that is basically the argument I have heard every somewhat intelligent conservative use. Except, they are usually less eloquent about it. Heck, I’m not sure that isn’t where the meme of calling UHC “socialism” came from. It could have originally a simplification of a metaphor.
As for the OP: I’ve seen Stewart do some good work, even though I don’t always agree with his actual points. I unfortunately discovered that watching the news lately, with their pessimistic predictions and fear mongering inflamed my anxiety disorder. Thus, I can’t watch Stewart as much as I used to, as half his show is essentially news.
Last night with Blonde Chick was even better. I’m sorry I don’t recall her name: my jaw became unhinged and I was stupefied by her ignorance and refusal to open her mind at all. If anything, I admired Stewart’s patience and forbearance with her.
Clue phone for those not in the know (not likely to be Dopers, but I can but try): RNs talk to patients and their families about “end of life issues” every. single. day. Doctors talk to patients about “advanced directives” (same thing) every. single. day.
Every single one of us above the age of about 35 should have AT LEAST thought about what they would and would not want done in case horrible tragedy strikes. To not do so is irresponsible. Just like adults should have wills regarding their financial affairs (but tend not to…). All that portion of the bill was saying was that docs would now get compensated for having such discussions and that they document them. It does NOT say that Grandma or Dad must choose “DNR” or “send me out to the ice floe”.
We “Do Everything” every. single. day. depending on the pt’s wishes (or family’s if the pt can no longer speak for themselves). Doing “everything” is upon occasion a great thing and all is well. All too often, though, Doing Everything results in a painful, slow death–treating the critically ill is nothing like on TV (not even House MD).
And guess what? Even knowing that things like invasive procedures, ventilators, multiple lab sticks, infections and sepsis, pain, loss of independence, and all the hazards of immobility (bedsores, deep vein thrombosis and probably resultant pulmonary embolism, muscle wasting, loss of dignity, depression, pneumonia, and possible kidney stones) can be god awful despite our attempts to prevent them, we will still Do Everything and willingly, if the pt or family so desires.
ALL that portion of the bill stipulates (from what was read last night) is that docs take more initiative than they already are (and I don’t know of many docs who don’t already do this) and keep a record of it.
She kept saying that the bill mandates this and that docs would “be punished” (lose reimbursement) if they didn’t do this. There is nothing wrong with either of those options. Keeping records of who picks what advanced directive is an excellent way of tracking trends. There is no judgement on which option you pick. And there is no penalty if you change your mind and decide later you want everything done (or nothing done). There isn’t now and there won’t be if and when this is passed.
For me, it all comes down to this: of just what is this woman (and others like her) afraid? A frank and needed conversation with her doctor? Is she pissed that her doc can get compensated for this? She made me wonder if she had ever been in a hospital or had a loved one die in one.
The ignorance is so profound and so entrenched, it’s sad. IMO, this woman fears death (as do we all) but instead of entertaining possibilities and doing what she can to decide her destiny, she is like a child with her hands pressed to her ears, shouting “lalalalalalalala; I can’t hear you!”
If this is the opposition, I’m not sure we can get this passed. It’s one thing to disagree; it’s another to refuse to engage at all. 
I plan on watching the rest of the interview after work tonight. At work today, I will likely ask at least 10 more senior citizens (and younger folks) if they have living wills or durable powers of attorney for health care etc–IOW, address end of life issues. (in same day surgery, we only go this far, unless the answer is positive, then we explore a bit more. For inpatients, this discussion goes a bit further).
Only if the book was available in large print, screamed into a CD by an old man on methampetamine, or written in gibberish on a pile of Burger King napkins, respectively.
The McDougall interview (video here) was intriguing and weird. It’s a hard-to-believe story, so who knows, but it was fascinating. And you’re right that Stewart and Colbert don’t get enough credit for being literary. Most talk shows won’t spend time on a book unless it’s a Harry Potter-size blockbuster or if it’s an autobiography “written” by a celebrity.
“Blonde Chick” is Betsy McCaughey, former lieutenant governor of New York and currently working for a research institute funded by Big Pharma. She is the person most responsible for the current hysteria over "death panels.
I admit there are nuances, of course. How many people (veterans and let’s assume each has a family) does that $33 billion cover? Can the program be replicated and scaled up to cover the entire population? How much are VA doctors and nurses paid (seriously, I don’t know, but I don’t expect it’s a huge amount)? Is there a rapid turnover as they migrate to better-paying jobs in the private sector? If a comparable program was possible, how many doctors and nurses would it need and would they accept a VA-style pay scale?
Personally, I think the anti-UHC arguments are absurd, but while the VA may be a success, I wouldn’t claim it proves a program to cover the entire population will be easy to implement.
Anyway, I’ll watch the complete interview with the blonde woman over the weekend. What struck me most is that while he frequently interjected his jokes and all, Stewart actually let her talk, which is a refreshing contrast to various Fox interviewers.
Afterthought, does Fox even have complete interviews on its website? I don’t know.
LOL I came in to say the opposite. I’m pretty firmly in the Obama camp, but I’ve liked that Jon is still making fun of who is in power and more importantly, pointing out foibles and inconsistencies. He still has a little bit more reverence perhaps for Obama’s camp than Bush’s but that’s understandable given that even though both have had screw ups, there’s a big difference in how they carry themselves.
I agree that there are many complicated issues to work out. I just wanted to point out that it’s unfair to dismiss the VA analogy on the grounds that it’s part of the US’s crazy military budget, since it isn’t. They’re entirely separate things. I have no idea if the VA can be scaled up or if it is a good model. It often does beat the private sector in patient satisfaction surveys, at least. I agree with you, though, that the arguments against UHC are generally asinine. I nurture the tiny hope that we’ll get to single payer in the US at some point.
I wanted to give this a little more thought. I’m bored, and my organization is collapsing around me as I type (there’s a big announcement going on at this very moment to that effect), so what the hell? Let’s take a look at the VA!
Here’s the proposed 2010 budget for the VA (PDF).
The VA is requesting about $37B for medical opertaions in 2010 (this does not include VA loan operations, burial benefits, etc).
In 2010, the VA expects to treat just over 6 million unique patients, including 515,000 non-veterans. I don’t see anything about the proportion of women, but although the VA may not have to deal with as much Ob/Gyn as does the private sector, the VA probably has a higher percentage of amputations, long-term rehab, and so on, so it’s probably a wash in terms of complexity of care provided.
In 2010, the budget calls for 15,932 physician FTEs (full-time equivalents). Salary + benefits for physicians is about $4.1B, making the average salary + benefits for a VA physician about $273,000. The average physician salary (without benefits) in the US appears to range from about $140K to about $270K. Add in benefits to those numbers, and the VA compensation looks to be about in line with what other doctors make.
Now, here’s my favorite part. Out of the $37B budget, I added up everything that looked like administrative overhead. Here’s what I got (all numbers rounded where I felt like it):
Admin Sal+Bene: 1.8B
Travel & Maintentenance: 0.6B
Transportation: 15M
Printing: 4M
Contracted Administrative Services: 327M
Total Admin Overhead: around $2.8B
2.8B out of 37B comes out to around 7.5% of the budget being burned in admin overhead. Put another way, about 92% of the budget goes directly to services.
In a thread a while back, I posted an analysis of how much private sector healthcare burns in admin overhead. I came upwith about 30-40% of revenue going to overhead, which jibed with some other analyses posted in that thread. I went on to arguethat we could compare private for-profit medicine to a non-profit like Shriners’ hospital, which boasts an adminstrative overhead of only around 6.5% of revenue.
So, I add to that earlier analysis that the VA is able to keep its admin overhead to about 7.5%, still way the hell lower than the vaunted private sector. Government inefficiency at work.
Can the VA model replicate that across a bigger slice of the US population? Who the hell knows? Kind of an interesting idea, though.
Re: the interview with Betsy McCaughey, I was glad to see that Jon let her talk, but was disappointed that her ‘counter-argument’ throughout the argument was: “You’re wrong”. And yet she wouldn’t explain herself when given the opportunity.
She kept talking down to Jon. What I heard from her was, “You just can’t understand what you’re reading here. You don’t have the background for it.”
His response was, “You see evil behind this legislation which is a valid POV, but you have to demonstrate it. Just saying ‘it’s happened before’ is not good enough.”
My paraphrasing obviously removes a lot of subtleties, but I think that’s an accurate ‘gist’ of what I heard.
I stand corrected on the divide between the VA and the regular military budget (though as a minor thought, doesn’t the latter include the immediate trauma care for injured soldiers as well as ongoing maintenance care like dental and optical for serving soldiers?), for which I thank the citers.
In my own experience in the Canadian military, most of the medical and dental personnel I’ve dealt with are themselves members of the Canadian forces and subject to its pay scales which, although having been boosted significantly over the last decade, aren’t exactly riches. I guess a valid concern is how doctors and nurses who work primarily for a public system might migrate in large numbers to higher-paying jobs elsewhere. Frankly, we’ve already had similar problems in Canada of doctors and nurses heading to the U.S. where the pay is better.
Just a potential concern, I figure. Of course, it’s entirely possible that many more doctors will choose to stay in the U.S. if the headache of dealing with private insurance companies goes away.