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Analysis of AMA Health Care Reform October 6, 2009

Posted by Daniel Downs in news.
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In a letter to President Obama and Congress, AMA President J. James Rohaback outlined seven tasks the American Medical Association deems necessary to make health care affordable and accessible to the general public. He wrote

* Provide health insurance coverage for all Americans.

* Enact insurance market reform that expands choice of affordable coverage and eliminates denials for preexisting conditions.

* Assure that health care decisions are made by patients and their physicians, not by insurance companies or government officials.

* Provide investments and incentives for quality improvement, prevention and wellness initiatives.

* Repeal the Medicare physician payment formula that will trigger steep cuts and threaten seniors’ access to care.

* Implement medical liability reforms to reduce the cost of defensive medicine.

* Streamline and standardize insurance claims-processing requirements to eliminate unnecessary costs and administrative burdens.

Several implications stand out in the above points:

1) The lack of any special interest issues like the public option, i.e. guaranteed provision for tax-paid abortions, demonstrates its appeal to the general public.

2) Its lack of “granny killing” statement doesn’t mean they don’t approve of it. The most said about counseling the elderly toward an early death (“granny killing, death committees, etc.) is that criticism of it is sad or dishonest. All politicians and abortionists say much the same about any criticism of their agendas.

3) Nevertheless, if the above were the extent of the federal heath care reform, the general public would support it. The proposal bureaucratic reform is far from being beneficial to the general public and the medical profession.

4) The medical profession and medical insurance stand to gain billions of redistributed health care tax dollars. It’s true, many Americans will benefit some, non-workers will benefit more, and the medical establishment and their investors benefit most of all.

To support the last point, consider what the AMA wants in the federal legislation. First, they want the federal government to provide health care insurance to all, which means increasing taxes whether as medical taxes or increases in cost of government-mandated insurance. Besides being a financial problem, it presents a legal problem as well. The federal government has no right or authority to provide health care. China or Cuba may such authority written in their national Constitutions but our Constitution does not. It is a right and authority only citizens in individual states actually possess.

Making health care more profitable underlies market reform (point 2), investment and incentives (point 4), repealing the Medicare physician payment formula (point 5), medical liability reform (point 6), and streamlining and standardizing claims processing (point 7).

Market reform along with taxpayer investment and incentives means more services to more customers for a lot more money.

Charging less than “market” rates or fees is a bad deal to any health care capitalist, even in an increasingly socialist “market.” That is why repealing the government fixed “market” pay rate formula must end. Who cares about the elderly on a fixed income, let the taxpayers pay.

Eliminating frivolous lawsuits is not a bad idea. What is truly bad is when physicians damage lives, lawyers get most of lawsuit claims, and damaged people pursuit of happiness is severely diminished. The type of legal reform needed is better screening and investigation of cases by which unwarranted claims are eliminated and due process in favor of the harm is thoroughly defended. If we have to pay for insurance, let the benefactors of our invested money and taxes pay up. If they would go bankrupt, it would only prove a better system of social insurance is needed maybe one without federal government’s involvement.

Good business practice always results in streamlining and standardization. I won’t hold my breathe for government to produce heath care efficiency or standardization. The tax code alone is proof of the impossible. Heck with tax code, some say Medicare is a bureaucratic mess.

The more positive points of the AMA reform list include:

1) “Eliminat[ing] denials for preexisting conditions.” Although this is mentioned under market reform, it is only marketable under government provided health care system. It is a welfare market reform, which means is marketable only to providers and voters.

2) “Assure that health care decisions are made by patients and their physicians, not by insurance companies or government officials.” This is probably the best part of the special interest proposal of AMA. Humans are not cars and medical insurance appraisers have no legitimate place in medical treatment. They do have a right to predetermine what they will or will not cover generally, but their involvement in medical treatment of patients is unconscionable.

Here again, the issue of insurance company profitable versus payout reveals the flaw in the system.

There are at least two identifiable solutions: (1) Government provided health care. Legally creating such a system requires a Constitutional amendment. It is requires Americans to adopt a more completely national socialism system of governance. The implication here is that federal legislative involvement in health care is illegal because by doing so Washington bureaucrats exceed the limits allowed by the supreme law of the land. Without a constitutional amendment, only the states have any legal authority over health care. (2) Another way to resolve the problem is to reform political economy so that all working Americans and their families could afford to insure themselves. This is a moral or ethical issue that does not require the adoption of national socialism but would require moral application to adjustments of the various markets including wage rates and an end to the myths of capitalism that are used for the benefit of relatively few.

For example, a few large national or international corporations who dominate 80% of any market in the USA tend to eliminate a whole lot of Americans from pursuing the American dream. Because this is the reality of many, if not most markets, the American Dream is more myth than real possibility for a majority of people under such a political economy.

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