Charlie Gibson sure does love him some old-fashioned “President Obama, when will you stop beating your wife for-profit insurance companies?” repetition, doesn’t he?
On the other hand, I think Obama did an excellent job of going right over the heads of Gibson and such hostile questioners as the head of the AMA and the insurance lobbyists, hammering the fact that nobody considers our current system viable, that even people who are satisfied with their personal health plans today won’t stay satisfied as premium costs continue to rise 9% a year, and that (at a conservative estimate) some 30% of current health spending is simply wasted.
Atul Gawande’s recent New Yorker article The Cost Conundrum has become a very Hot Topic, according to the media. I’ve been reading Gawande’s books, COMPLICATIONS and BETTER: A SURGEON’S NOTES ON PERFORMANCE, and trying to write a review more coherent than “Read these! Damn fine!” Large chunks of both books originally appeared in the New Yorker, but reading or re-reading essays on everything from surgical training at one of America’s best hospitals, to the fieldwork behind the attempt to eliminate polio, to the amazing advances (and failures) in trauma medicine during our latest military adventures in Iraq & Afghanistan really provides a new perspective.
Seebach
“Read these! Damn fine!” may be the best review there ever is. I’ve found the more important a work is, the less I can say about it.
mr. whipple
Yup. Quite possibly, the worst thing i’ve ever seen on teevee.
Every question is asked by people who are ‘THE HAVES’.
Drs, insurance people, etc.
Not a single person who is a ‘NOT HAVE’, and none of the ‘HAVES’ are willing to give one inch, one iota, one speck, even tho at the outset when Obama asked them, everyone in the room agreed the system is broken.
Not a single person who is uninsured, or gone bankrupt, or has been denied, or has gotten rescinded or otherwise fucked over, until 3 minutes left in a 1 1/2 hour show.
And every question asked by Gibson in the most biased, vile way possible.
Comrade Stuck
I didn’t watch it but just read the play by play from Tapper and company. This is the part that stuck out to me pushing back on the meme of a public option causing businesses to just drop coverage for it’s employees in liew of the PO. It is the most potent attack the wingnuts have so far imo, and Obama needs to come out with a counterweight argument, which he kinda did.
The only way to do this, seems to me, is to make companies pay a comparable amount into the public plan if they don’t provide a private one for their workers.
Jim Pharo
You should also check out the “Overtreated” book that covers a some of the same ground in more detail (and was first!)
iluvsummr
Damn — I missed that. Is “prescription for healthcare” online anywhere?
Absolutely love Gawande’s writing. Read Complications years ago and the story that sticks in my mind is the doctor who has a hunch that what’s ailing his patient is flesh-eating bacteria, is absolutely correct and saves said patient’s life because of that hunch. Showed how medicine is part art/intuition, part science.
harlana pepper
Don’t cry for me Argentinaaaaaaa!
BDeevDad
For a revealing perspective go here for an insider’s view of those profits
Also this.
Allan
Charlie Gibson. [shudder]
Did he pull out his W-2 and ask Obama to show him how much this was going to cost him like he did during the debate?
Because the most important question on Charlie Gibson’s mind is always, how does this affect overpaid RW wankers like me? Goddammit, I’m not made of money! Well actually I am, but I like my money and I’m not giving any of it back just so these alleged poor sick folk can stop giving each other TB down on the subways on their way to and from cleaning my toilets. And why can’t I find a maid who knows how to fold the TP into that little point AND talk English?
BDeevDad
Damn middle of the night moderation hell.
Nellcote
Half way through on the west coast. Gibson’s his usual hostile self. How laughable that the winger’s are freaked out because of liberal ABC. I expect Gibson to hit all of Luntz’s talking points before it’s over.
On the other hand it allows Obama to respond directly with a minimum of filter.
We’ll see if that’s a good thing.
Allan
@iluvsummr: It’s on the ABC.com website. Follow isolation and sterilization procedures before entering there, because it’s infested with pop-ups and commenters who appear to be logging on from a compound somewhere in Idaho.
cj
That question from Gibson was priceless. He asked Obama *I’m paraphrasing it* “There are 46 million uninsured people wouldn’t the doctors be overrun by patients if those 46 million become insured”
WTF! Do Gibson not know that doctors are already overrun by patients, especially in the ER. Also so we shouldn’t insured millions of people in fear that doctors will have more work.
Isn’t this a good example that insuring more people will actually create more jobs i.e more doctors, more nurses, more hospitals, and all other jobs in the medical field.
I also hate that Gibson was always trying to interrupt Obama when he was talking.
Turgidson
Gibson is just mad at himself for accidentally exposing Palin as a disgrace and fool and adding a nail to McCain’s electoral coffin. He might actually have to pay another 3% in taxes in a couple years now! The horror!
Don’t feel bad, Charlie. How were you supposed to know she’d botch a question that even a braindead anteater could handle? If it hadn’t happened in your interview of her, it would have happened at the next (non-Hannity) interview.
Still though, it’s annoying that he only feels the need to seem “tough” with Obama, when he’s a softball-throwing hack with everyone else. Thankfully Obama appears to have handled himself fine, as he tends to do, and Gibson just looked like a jackass to the non-teabaggers (ie 80+% of the country).
Allan
Mommy, why is that old man so angry with Obama?
eyeball
Nice post, Anne.
dave
nice post indeed.
if it wasn’t for my basic human decency, i would wish that charlie gibson get a nasty case of FLESH EATING BACTERIA. or at least a dose of unemployment. or a cup of shut the hell up.
Linkmeister
So Gibson exhibits his usual cluelessness again, huh? I won’t forget the loud laughter he got when he suggested that a married Uni professor couple made over $250K and thus would have their taxes raised by Obama. It’s a pity he apparently has forgotten it.
Addendum: Photo caption at ABC News.com: http://abcnews.go.com/politics
“In ABC News health care forum, Obama struggles to explain whether his proposals would force normal Americans to make sacrifices that wealthier people wouldn’t face.”
inkadu
Here there implicit problem is, “And wouldn’t rich people who have medical insurance suffer as a result?” Nothing to see here, move along.
On this point, I am in a developing country right now — the same one Sanford just left — and there are doctors all over the place, all educated at state-run schools for free. Being a doctor is still a prestigious profession, but people go into it to work, not to retire.
If we are going to fix health care in the US, we definitely need to take doctors and medical school down a peg or two.
BDeevDad
Deleted
InflatableCommenter
@Comrade Stuck:
Good suggestion. Obama has also stressed throughout that reforms were to be phased in, so that there would not be precipitous changes taking place and leaving people stranded, confused or forced into scenarios they didn’t want.
@iluvsummr:
abcnews dot com has the entire program in stream form, as well as individual highlight videos.
@Nellcote:
My impression is that the ABC team is going with a list of tough questions which sound for all the world like questions the Obama team would want them to ask. They don’t want softballs, they want the tough ones so that they can get in front of them.
Anne Laurie
To be scrupulously fair, the prime-time block did include the nursing student who asked what could be done to keep ERs from being further overrun, and the medical student who wanted to be a primary-care physician if it weren’t for $300K in student loans. I thought they looked a hella more sympathetic than the head of the AMA pouting, or the pinch-mouthed shill from the Lewin Group bitching that a public option might damage insurance groups’ profits. And Obama responded by talking about creating good jobs for nurse practioners and other health care workers, and by touting loan forgiveness for new doctors willing to provide primary care, especially in underserved regions of the country.
Obama also repeated that “Our plan will cost me, and Charlie Gibson, a little more money in taxes, but WE can afford that” at least twice… in other words, he made it clear just exactly why Charlie was whining about “risky, unproven” plans that would “destroy health care as we know it”. Advantage, very much Obama, I thought.
Cantrill
Anchor Charles Gibson, from the Blue Room at the White House, set up the piece by highlighting how people are happy with their health care, but: “Our new ABC News/Washington Post poll shows 83 percent of Americans are very or somewhat satisfied with the quality of health care. They pretty much like things the way they are.–HuH?
But what I wanted to post was this
Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee.
Zuzu's Petals
@Turgidson:
You mean he might actually have to pay what he was paying in 2001.
geemoney
One of the things that sticks in my mind is a talk that Tim O’Brien did on The Things They Carried. Basically, he said that he always found it hard to talk about the book because everything that he wanted to say was already in the book. I just thought that was awesome. I also think that it is one of the things that makes literary criticism so hard, and why sometimes you are reduced to just passing on admiration for a work. If it is a work that is making arguments for something, and you happen to agree with what is says, sometimes the best you can say is, “Yes, that’s right.”
IndieTarheel
@InflatableCommenter:
That may be true, but this –
isn’t tough, that’s CERTIFIABLE.
Xenos
@IndieTarheel: If those doctors would be overrun, then there is a severe shortage of doctors in this country. The AMA wouldn’t have anything to do with that, would they?
Fulcanelli
And of course the fact that Charlie Gibson is most likely a member of the American Federation of Television and Radio Artists Union and has a great health coverage package as part of his {shudder} America-destroying Union Membership was disclosed from the outset of the program, right?
[thump, thump] Hello? [thump, thump] Hello? Is this thing on? [ooooowwwww, howl of feedback]
gex
@inkadu: My brother graduated summa cum laude from the University of Minnesota’s School of Biological Sciences. He he’s been applying to med schools for 2 years and none of them want him. Apparently we *like* having a shortage of doctors.
I would have been tempted to snarkily ask if we should maybe kick more Americans out of the insurance system so Charlie doesn’t have to wait more than 5 minutes for an appointment.
Napoleon
@Comrade Stuck:
I thought that is exactly what they want to do.
The Other Steve
So we get this statement from Cigna for our son… Basically it says the Hospital sent them claims for about $3,000 relating to his birth.
But they aren’t going to pay them yet until we show proof that we don’t have him covered under some other insurance policy.
We’ve always had our insurance individually. My wife had a single plan with her employer and I had one with mine. When Alex was born we upgraded my wife’s policy because they had an option of self+1 child which was cheaper then selected a family plan. So he’s on her insurance. Not mine.
But the insurance company is wasting everyone’s time because they think that because we are paying them the premiums they might not actually have to pay. That we might also be paying premiums to another insurance company, and they could get those other guys to pay.
It makes no sense, but it wastes everyones time.
Aaron
@InflatableCommenter:
I got that same feeling, IC. The questions were as they had to be – there are a wealth of talking points (and virtually every one was raised by Gibson and the questioners) that had to be rebutted before anything resembling substantive debate could take place on the topic.
While having the uninsured and those bankrupted by medical bills on would have been emotionally powerful, I am not sure it would have changed the debate. Then again, the people most against a Public option and expanding health care seem to be more concerned about moral hazards than health hazards . . .
and that is why I call those people ass holes :-)
Napoleon
@cj:
Shorter Gibson “Let them eat cake”.
Comrade Stuck
@Napoleon:
The point I was making is, that Obama should zero in on this solution whenever he is questioned about the problem of companies dropping their private plans. I am aware that this has been occasionally tossed out as a solution. But usually Obama just gives a generic answer like the one I quoted from last nights event.
Aaron
So wait, Gibson just basically admitted that, under the current system, all of the uninsured people are dead-weight loss? That is some aristocratic bullshit, there.
The thing is, and Obama has mentioned this many times, the current system is broken. that should be the gist of every argument on healthcare for the foreseeable future.
Svensker
Our Wall Street friend told my husband yesterday that he resented the idea of having to pay for medical treatment for some fat-assed poor person who was too ignorant or lazy not to realize that eating at Mickey D’s wasn’t the healthful option.
Our friend is morphing into Charlie Gibson — former liberal, current asshole.
Aaron
Another thing I was thinking of, and please disabuse me of this notion if it is incorrect . . .
Will not the number of people enrolling in the public plan allow the government to negotiate cheaper drug prices? If so, what sort of savings could this alone account for? I believe it is Medicare that currently can leverage its size to get cheaper drug prices from big Pharma.
WereBear
While I resent the idea that many potential retirements evaporated because Wall Street was playing Video Poker with real money.
Barbara
To “The Other Steve”: Get your “other insurer” or your employer to write a letter to the one you want to insure your son stating that there is no coverage under the other insurer. You can write the letter for the employer, but it has to go out under the employer’s letterhead. Make sure you have a direct contact to send it to, and send it with any EOBs or whatever else they have given you that shows the background of what is going on.
Don’t get me started on COB. If there is any reason for a single payer, COB is it.
Napoleon
@Aaron:
Your post reminded me of this from A Christmas Carol:
“At this festive season of the year, Mr Scrooge,” said the gentleman, taking up a pen, “it is more than usually desirable that we should make some slight provision for the Poor and destitute, who suffer greatly at the present time. Many thousands are in want of common necessaries; hundreds of thousands are in want of common comforts, sir.”
“Are there no prisons?” asked Scrooge.
“Plenty of prisons,” said the gentleman, laying down the pen again.
“And the Union workhouses?” demanded Scrooge. “Are they still in operation?”
“They are. Still,” returned the gentleman, “ I wish I could say they were not.”
“The Treadmill and the Poor Law are in full vigour, then?” said Scrooge.
“Both very busy, sir.”
“Oh! I was afraid, from what you said at first, that something had occurred to stop them in their useful course,” said Scrooge. “I’m very glad to hear it.”
“Under the impression that they scarcely furnish Christian cheer of mind or body to the multitude,” returned the gentleman, “a few of us are endeavouring to raise a fund to buy the Poor some meat and drink, and means of warmth. We choose this time, because it is a time, of all others, when Want is keenly felt, and Abundance rejoices. What shall I put you down for?”
“Nothing!” Scrooge replied.
“You wish to be anonymous?”
“I wish to be left alone,” said Scrooge. “Since you ask me what I wish, gentlemen, that is my answer. I don’t make merry myself at Christmas and I can’t afford to make idle people merry. I help to support the establishments I have mentioned: they cost enough: and those who are badly off must go there.”
“Many can’t go there; and many would rather die.”
“If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population. Besides — excuse me — I don’t know that.”
Napoleon
I think they are forbidden by law from negotiation drug prices, which is a complete rip off of the public treasury courtesy of your elected representatives.
Jackie
@Aaron: Unfortunately the medicare part D legislation actually flat out prohibited the government from negotiating prices for the covered drugs.
Skepticat
He’s probably right in one aspect. People are happy with their health care—it’s the health insurance to get care that’s the problem. My premiums doubled over six years, so I no longer have insurance. Or care.
When I owned my own company, I paid 100 percent of my employees’ health insurance, and that has a lot to do with the fact that I retired early.
Davis X. Machina
Correct. 2003 legislation spawned by Billy Tauzin, the orignial Blue-Dog, party-switching POS who now heads PHRMA.
Wexler’s H.R.1832 would repeal this provision. Still in committee, as far as I can tell. What it’s doing bottled up there is beyond me.
valdivia
Can Gawande be our Surgeon General? I am putting forth that he should be nominated.
J.D. Rhoades
So the new GOP attack point seems to be, under “ObamaCare,” those on the public option will have inferior health coverage to the rich.
As opposed to what many of them have now, which is nothing. Am I getting this right?
tripletee (formerly tBone)
I remember when Charlie Gibson aggressively questioned President Bush in a town hall meeting during the run-up to the Iraq war and expressed concern about the trillions of dollars and thousands of lives it could cost America.
Oh wait, no I don’t, because THAT WOULD NEVER HAPPEN. Charlie Gibson and the wingers bleating about “liberal bias” at ABC can go eat a bag of dicks.
Aaron
@Davis X. Machina:
Thanks you for the info. After doing some research, it was the VA I was thinking of. A report was done on the issue, and some of the numbers are below.
A Hidell
Yeah, COB’s annoying, but in a system where there are literally thousands of potential payors, it’s necessary. The important thing is to keep on top of it. COB is almost always triggered with a newborn, so some pre-emptive calls to your insurance company during pregnancy can make things a lot easier.
oh really
And this may significantly understate actual premium increases. In addition to the annual increases, most, if not all, private insurance is organized around age cohorts. When you change cohorts, you get an additional substantial increase, which gets worse as you get older (and less able to switch insurers because of age, pre-existing conditions, etc.). That means that every five years the 9% increase (gee, all I saw was double digit increases) becomes an 18% to 25% increase. My last 20+% jump made my insurance unaffordable.
IndieTarheel
@Xenos: I was attempting to be snarky. I obviously missed. When I said certifiable, I meant in the white-coat-that-snaps-in-the-back kinda way.
Bubblegum Tate
I read that New Yorker article yesterday. It is terrific, if a bit depressing.
slag
Listening to it now. I actually have no problem with the tenor of the questions so far and appreciate Obama’s deftness at handling the crux of the issues.
Specifically, I highly valued the end of life conversation and Obama’s brief reference to “culture” in it. I often wish we could take more steps back when discussing the big “life” issues and use them as a lens to investigate our own cultural norms and rituals rather than treat life and end of life with our traditional level of mythological/mystical reverence. In some ways, I think our inability to look at these issues a bit more rationally keeps us from addressing them in real terms.
One thing I did object to was Charlie Gibson’s unnecessary interruption of the conversation when Obama was explaining how we could avoid having people forced off their current insurance. Also, I would agree that the conversation was overwhelmingly skewed toward people who already have insurance and treating the uninsured as numbers instead of people.
Waingro
Your friend (along with most wingnuts) also has no fucking idea how insurance works.
Of all the stupid talking points, ‘I Don’t Want To Pay For Other People’s Medical Treatment’ is the most transparently stupid. That’s sorta how insurance of any kind works- everyone pools their money from premiums (or gasp, taxes) into a big pool and if someone needs it, the money is there. This is Insurance 101. Bigger insurance pools are more individually affordable and efficient.
Jesus, glibertarianism just makes people stupid.
Elie
Comrade @ # 3 —
I say just fine to the employers who want to drop coverage — as long as we have the public plan, the more the better. After all, isnt that part of the point of this? That is to reduce employer costs?
Also, it just speeds the day to the universal solution so I hope lots of em drop out — as long as their people keep coverage some other way…
PeopleAreNoDamnGood
@Elie:
Me too. From what I have seen, small employers often offer shitty healthcare insurance. And while they are doing this, it is costing them greatly.
The party that pretends to be the party of small business seems oddly stubborn it its refusal to create reforms that would really help huge numbers of small businesses.
Odd.
Elie
@ #52
I have no problem with skewing the conversation towards the Haves at this point…This is tactical. We must surface the dissent to deal with it and that is where the dissent is.
We all realize of course, that there are many levels of Have Nots — but they are not the ones who are going to mobilize and have the power to stop this. We have to move some of the Nos into at least not acting on the Nos. Obama has to split the insurance companies and providers’ profit needs from the true interests of even the well to do RECEIVER of services. This is the only way to do it. They have to be asked to talk and talk and talk to surface their issues and also make clear their differences from most folks. Right now, they are protecting themselves by projecting an image that they have the same interests as the subscribers or patients buying their services. Quite clearly that is NOT the case, but the people have to see it for themselves over time…
Elie
Peoplearenodamnedgood @ 55 –
Yep. And it (the cost of providing even mediocre health benefits), puts them at a competitive disadvantage with other small business that do not provide any coverage or worse coverage. We will not be able to compete internationally at all without doing this. The big employers have to know that this is true even as they bark and bark about pretending that they don’t want to shed this cost.
Its the health care industry that is apoplectic – particularly the big insurers and big providers. I imagine with time we can peel off the big providers too by lowering their costs of doing business, leaving the naked hard core of resistance of the insurers. Make no mistake, they will fight this to the last breath and trillions of dollars of profits are at stake for them — trillions that WE can apply elsewhere other than supporting their and their shareholder’s lifestyles.
I say this with great bravado but my employment is in this sector and I know that it might effect me. So be it.
Kewalo
In 2007 the congress passed a bill that would have allowed the drug bill to negotiate prices with big pharm. It was one of Bush’s first vetos.
After watching the show last night I honestly don’t have any hope left that we will get a bill that is for the people.
Anyone else notice how respectful they were of the CEO from Aetna, Ron Williams. Well, check this out and then tell me that the insurance companies plan to help out real people.
I was just sick after the show. It’s become very clear to me that our tax dollars will be going to feed the profits of the greedy, bloodsucking insurance companies.