As mentioned earlier, last week I went to see Wesley Clark speak at a rally here in Knoxville, and as promised, here is a complete deconstruction, some would say demolition of his platform.
The biggest thing that struck me during his speech was that he barely mentioned Iraq at all. In fact, if I remember correctly, he never even said the word "Iraq." In his introductory speech, David Keith alluded to Clark's toughness, and that was really as close as they got to the issue, which is odd, since Clark's military background is supposed to be his greatest campaign strength. But we'll discuss that in a little bit.
Clark opened as expected, by attacking President Bush, claiming that the economy has lost jobs under the President's leadership. As is usual for the opposition party, he failed to note that the recession began prior to Bush's election, that jobs are actually on the rebound, spurred on by the Bush tax cuts, or the newest information that suggests that unemployment, which peaked at a relatively low for a recession 6.2%, was actually overstated, as new enterpreneurial startups were not captured in the data. But then again, you don't expect a guy who's running for president to say anything good about the incumbent.
What you do expect, however, is a coherent plan for his administration, and Clark completely failed to deliver one, delivering instead a liberal wish list, much like a kid going to Santa with his Christmas list, and about as grounded in reality.
First, he plans to raise the income of every family by $3000.00. But he provided no details on how he planned to do it.
Next, he plans on cleaning up the environment. Again, no details on how he plans to do it.
Third, he's going to send 1 million more kids to college. Again, no details on how he's going to do it.
Fourth, he's going to lift 2 million kids out of poverty. Again, no details on how he's going to do it.
Fifth, he's going to provide access to affordable health care insurance for everyone. On this one, Clark does appear to give some details, but appearances can be deceiving as we are about to find out.
During his speech, apparently ad libbed since it' not in the prepared transcript, Mr. Clark said he wanted to give every American the same healthcare benefits he had while in the military. Since many of you have not been in the military, let me give you a few details on what this actually means.
I'll let you decide which is more prevalent, but I'll tell you a personal story. A guy fell down a ladder (navy lingo for very steep staircase) and lay stunned at the bottom. A sailor found him, asked him if he could get up. The guy tried, but couldn't move his legs and seemed disoriented. The sailor stopped him and called away a medical emergency. The highly trained emergency response team showed up and assessed the situation. The sailor gave them the pertinent information, at which point the PA asked the fallen man to try and stand. The man tried but still could not move his legs. The PA then grabbed the injured man's hand and tried to haul him to his feet! Eventually, they brought down a back board and strapped the poor fellow to it and Started to haul him out of the hole. I say started because the only strap they tightened correctly was, you guessed it, the chin strap. He dangled off the board by his neck until the concerned sailor yelled at the PA. They lowered the poor bastard down and refastened the straps, and hauled him off to medical. Fortunately for the injured man, his spinal cord was pinched, not severed, and after a couple of weeks, he was walking again.
I was the concerned sailor who called away the medical emergency.
I've also seen misdiagnoses galore, and at least one instance of an allergic sailor, clearly designated as such in his medical file and on his dogtags, nearly given a fatal dose of penicillin during assembly line style vaccinations.
That, folks, is military health care in a nutshell, and Clark's use of it as a basis for his health care plan only serves to reinforce a basic truth of life:
There Ain't No Such Thing As A Free Lunch. The more they promise to give you, the more they take away in return.
Clark went on to designate a three pronged approach in his healthcare plan.
First, he's going to concentrate on prevention. He wants to give everyone access to preventive checkups, and diagnostic screenings to catch disease early, and hold down long term costs. In the military model, this is accomplished by making such checkups mandatory. You can be subject to disciplinary action if you don't go to an assigned physical. The civilian equivalent could be something like denial of coverage if you failed to get standard screenings done.
Is that really going to appeal to most people?
Second, he wants to guarantee health insurance coverage to everyone to the age of 22.
And third, he's going to give extra assistance to what he calls "vulnerable citizens", those between jobs and low-income families.
Now, if you've been adding in your head, you can see that his health care plan alone is going to cost billions of dollars. How does he plan on paying for it? By revoking the Bush tax cuts on everyone making over $200,000 per year. Just for fun, I went to the IRS page and checked out just how many people were making over $200,000, and how much they were paying in taxes. It turns out that in 2001, after the first round of Bush tax cuts, there were about 2.6 million returns filed with an AGI of $200,000 or greater, representing about 2% of all returns filed. They paid $336 billion in taxes, or 41% of all income taxes collected by the IRS in 2001. Yep, 2% of taxpayers, those Mr. Clark wants to raise taxes on, paid 41% of all taxes collected.
But wait, there's more! While those who made less than $200,000 paid an average of 8-12% in income taxes, those making over $200,000 paid an average of around 24% in income taxes. Those evil rich bastards not only paid more than anybody else, they paid a significantly higher percentage of their income.
But wait, there's still more! (And this sounds the death knell for Clark's health care plan). If Clark rolls back both Bush cuts for everyone who makes more than $200,000 per year, and if the economy roars along, then, based on the difference in collections from 2000-2001, we can expect to see an increase of just $83 billion. (This ignores the negative effect of inflation and the dampening effect on the economy of the tax increase, and is therefore a slightly optimistic projection.)
OK, Clark claims the he's going to provide access to affordable health insurance to every American, and guarantee coverage for every child until they are 22. (A 22 year old is still a child? Welcome to the nanny state. Check your autonomy at the door.) By his numbers there are 44 million Americans without health insurance. Simple division shows that it works out to $1886.36 for each person without insurance.
Does anybody know where I can get a year's coverage for $1,900? I'm paying (my contribution plus the company's contribution) close to $850 per month for family coverage, which would work out to about $3400 per person for a family of 3.
Why is it that some folks refuse to do simple math?
You can check all my numbers here, at the IRS website.
By necessity, Clark's health care plan alone is going to necessitate monstrous tax increases, and not just on the wealthy, as well as cuts in other areas, and that's not mentioning his plans to raise family income, send kids to college, etc.
it's all pie in the sky folks, smoke and mirrors, and the people backing him are hoping we're dumb enough to buy it again.
Here's another example of sizzle masquerading as steak. On his website, Clark wants us to hold him accountable to specific goals that he promises to reach at the end of his first term.
I, Wesley K. Clark, promise to show the leadership to achieve the following five goals by 2008, while reducing the budget deficit each and every year, and to ask the American people to hold me accountable for meeting these goals:The typical family's income will increase by $3,000.
I will put in place policies that will prevent 100,000 premature deaths from environmental causes by 2020.
1 million additional students will enroll in higher education.
2 million children will be lifted out of poverty, bringing the poverty rate to lowest on record.
30 million people who currently lack health insurance will get it.
That's pretty cool, right? I mean he's got numbers and everything. No way to weasel out of that, right?
Wrong!
1 million more kids in college. OK, more than what? Current enrollment? In that case, population increase will have you there without having to do anything. Or more than what is projected currently? Projected by whom? Ask the same questions about family income. $3000 more than today, or $3000 more than as currently predicted under the Bush plan. Specific goals are meaningless unless they are referenced to a concrete starting point. But again, the Clark campaign is hoping we aren't smart enough to catch that.
Well, OK, you say, but Clark's strength wasn't domestic policy anyway. We like him because he has the military background to take on Bush over the handling of Iraq.
Ok, so why didn't he talk about it? Why isn't he running on that?
Maybe, it's because he knows that if he does, his early removal from command of the NATO forces in Kosovo will come up. There are only two reasons for an early relief at his rank. Either a senior officer suddenly dies and must be replaced, and he's the only guy for the job, or the officer being relieved, for whatever reason, is deemed as no longer able to carry out his duties effectively.
That's it, no other explanation exists, and since nobody died, and Clark wasn't promoted, we can only conclude that the latter explanation is accurate. Adding support to this theory, is the infamous attempt by Clark to order NATO troops to attack Russian troops, and his direct superior officer, Gen Hugh Shelton, who said that Cark had issues with integrity and character, and that those issues led directly to his removal from command and early retirement.
Despite these lurking issues, Clark has spoken out recently on defense, and the US military.
Well, if I were president right now, I would be doing things that George Bush can’t do right now, because he’s already compromised those international bridges. I would go to Europe and I would build a new Atlantic charter. I would say to the Europeans, you know, we’ve had our differences over the years, but we need you. The real foundation for peace and stability in the world is the transatlantic alliance. And I would say to the Europeans, I pledge to you as the American president that we’ll consult with you first. You get the right of first refusal on the security concerns that we have. We’ll bring you in. [Emphasis mine]
Wow. He's going to give Europe the authority to tell us whether or not we can react when our security is threatened, and the right to dictate how we respond, if they allow us to respond.
So, to sum up his candidacy, his platform is the worst sort of cotton candy, all fluff with no substance; the only area of his platform that is fleshed out at all will bankrupt the country (and still fall short); and his foreign policy consists of the stated goal of handing over our security to Europe, which in light of his performance under fire in Kosovo may not actually be a bad thing if he were to become president.
Posted by Rich at December 19, 2003 1:15 PM | TrackBackGreat post! An absolute slam dunk. I am retired Army and Clark's candidacy just repels me. His Europhilia is frightful. I'll definitekly link to this just as soon as Blogger's FTP returns to service.
Posted by: Donald Sensing on December 19, 2003 4:48 PMThanks for an excellent post. I was in the Intel Community during Kosovo, working with the Services, and myself and everyone I talked to, in the Services and out, were appalled by Clark's "leadership". The phrase most commonly used was debacle. It is no surprise to me he is running on such a platform. Further, his recent claim that he would have apprehended bin Laden by now is both stupid and odious. Indeed, a frightful man.
Posted by: C. Owen Johnson on December 20, 2003 3:44 PMAs a woman who was an enlisted Marine's spouse, Clark's desire to model military healthcare makes chills run down my spine. 10 minutes not enough time with the doc for you? You get 5 with a military one and don't you dare ask questions. You will at all times be treated as NOTHING. Clark wouldn't have enjoyed his doctor visits if he'd been on the low end of the totem pole. Great post; thanks for the heads up on Clark.
Posted by: Ex-military spouse on December 21, 2003 7:00 PMI haven't finished your dissection of Wesley Clark's speech, but I wanted to mention a couple things you missed about military health care.
First - vaccines galore! The entire nation can stand in line, several times over a two or three weeks, and get shot in both arms more than once.
Second - AGGRESSIVE treatment for fever. I once got sick and wound up in ice baths and, when I could stand, cold showers. This was all to treat a 104 fever. Might have been called for but it sure was cold and it didn't seem to last long.
Third - the opportunity to try new and wonderful treatments and drugs. Someday, somebody will do an expose about how US military personell have been unwittingly used in testing for drugs. Some of those are now approved an available either by prescription or OTC, others have been quietly shelved.
But you may get the finest trauma care known to man if you need it.
Posted by: Ray on December 21, 2003 8:01 PMAs far as I can see, what you're doing in this deconstruction is: taking one line that Clark ad libbed and using it to draw all sorts of scary conclusions about what he has in mind without bothering to check his actual proposals to see whether your extrapolations bear any resemblance to reality. If you check out Clark's actual health plan, what he proposes (for adults) is this:
"The plan would allow Americans without access to job-based health insurance to purchase coverage through the same system that insures members of Congress. The government would ensure that the premiums paid by individuals are fairly priced and available to all eligible people. This policy would especially help older adults who have diminished access to job-based coverage, increased need for services, and great difficult in finding affordable, accessible insurance in the private, individual market." http://clark04.com/issues/healthcare/
There's a third-party assessment of the health care plan's costs here: http://clark04.com/issues/healthcare/clarkplan.pdf
And don't forget that actuarially, health insurance should be less costly for young, fit, healthy individuals -- like those in the military. Same issue arises with the kind of coverage our representatives in Congress get -- generally these are folks who've had access to excellent care all their lives, so they're generally quite healthy when they hit the system. Cost control will be a bit harder if you extend that kind of coverage to millions of fat, coffee-swillin', hard-livin' bozos like me.
Typical recipe for disaster. No thanks, General.
Posted by: DrSteve on December 21, 2003 9:02 PMIn response to your Navy healthcare, here's a similar horror story. My boyfriend was going through Marine Corps boot camp and was jumping down off of an obstacle. He had landed the wrong way and had broke his left leg in five seperate places. When he wasn't able to get up, the medic that treated him gave him some asprin and was told to continue on the course. Now, I know the Marine Corps is supposed to toughen you up, but it wasn't until someone later inspected his leg and noticed that you could push into it and the flesh wouldn't pop back that he was taken in for treatment. He's gotten vaccines that haven't been approved for the general public FIVE TIMES. Don't even get me started on his dental treatment. I had to drag him to a dentist off base that we had to pay for ourselves.
Posted by: kipp on December 21, 2003 9:18 PMIf Clark thinks that military healthcare is the best care available he needs his head examined.
I remember a particlarly bad incident while serving with the 3rd Armored Cavalry Regiment years ago. I had to drive a trooper back to the base hospital from the field. I was told not to hurry as this soldier's wife was admitted as a result of "routine procedures."
Actually his wife had suffered from pneumonia and was refused admittance because she was told she only had a cold. After initially being denied admission on SEVERAL occasions she finally was admitted to the hospital.
By by the time I drove this guy back to the hospital his wife had died. I'll never forget his look when he found out his wife had died minutes before we got to the hospital.
No one I knew would ever want the military to take care of their health after this incident.
Posted by: bootswebb on December 21, 2003 9:20 PMClark is as nutty as Dean:Except perhaps for colonoscopies, everyone already has access to "preventive checkups". They simply don't cost that much as compared to anything else. But the public is lax or thinks it not worth the few hundred dollars a year, at most, to get checked -- or that it is unjust to have to pay. Power to the people!
Who among HMO patients has even been advised to get such checkups? [I don't know if they do this at all.]
Mass checkups do prevent some morbidity, but probably not much money net, if any. The Government will not like this.
Real preventative measures are mostly free: diet and weight control, smoking and drinking decrease, exercise, immunizations, maybe stress reduction. Everyone knows about these things, but what percent acts? Health improvers can even increase money spent on health care if longevity increases. The Government will not like this.
Posted by: Joe Peden on December 21, 2003 9:31 PMSo, just to be clear - when it suits you, military good and honorable, but when it might be used by a scary liberal, military odious and baaad?
Yep.
What a convincing takedown.
Posted by: SuiJuris on December 21, 2003 9:41 PMMy dad served in the Army Medical Corps during World War II, then later worked in both the Veterans Administration and the private sector. Many times he told me that military medicine is populated by mediocrities who'd never have made it in civilian life. That is just one among many burdens placed on our armed forces -- who sacrifice their freedom AND the right to better health care as part of the price for keeping us free.
Socialized medicine will destroy the best health care system in the history of the world. To implement it will require destruction of personal freedom on an unprecedented scale. Clark's glib pronouncements about imposing military standards on civilians betray all of us -- especially those in the military who give up so much to keep the rest of us free.
Thanks for pointing out this horror. I'll never vote for the guy.
Posted by: Eric Scheie on December 21, 2003 9:45 PM
The term "scare tactics" has been expanded to cover just about any policy with which one side of the aisle might disagree, but reading Eurofantasy stuff like Clark's domestic platform redraws the line. This is scary. Who does this yo-yo think he is?
Interestingly enough, a friend of mine saw Dean at a fundraiser in LA. His speech was much like Clark's: three lines on the war on terror, half an hour spent on a welfare state pipe dream.
Posted by: Garindan J. on December 21, 2003 9:55 PMHaving spent 9.5 years in active duty with the AF - I'd say that military health care is okay for folks who are generally healthy, but not those with chronic conditions (such as anything that would disqualify you for the military) or anything out of the norm pediatric-wise. Trauma care is great. Psychiatric care... iffy. Geriatric? Don't make me laugh.
Anything else... well, when you've got to wait six months for an optometrist's appointment, it really makes you appreciate chains like LensCrafters.
Clark's medical plan sounds good - until you look into it. The rest of his platform's about as solid as jello. But then, the current crap, er, I mean CROP, CROP of candidates strike me as the most unimpressive bunch of Presidential wanna-be's in history. Or maybe I'm just looking at them too critically...
J.
Joe,
"...Who among HMO patients has even been advised to get such checkups? [I don't know if they do this at all...."
My HMO experience is entirely at odds with this description. More kinds of checkups than I would accept at zero additional cost except for possibly co-pays.
Regards, Don
Clark couldn't get elected dogcatcher in Little Rock. He's a f*****g idiot.
Posted by: Buster on December 21, 2003 11:29 PMHere's something to add to your analysis:
If we suddenly add 44 million people you cite to the healthcare system, who the heck is going to provide care for them? We already have a shortage of general practitioners and nurses and it takes about a month to see most doctors for routine visits. How much longer will you have to wait when they suddenly increase the patient population by 15% or more???
Posted by: Nash on December 21, 2003 11:39 PMBelieve me I am no fan of the Democrats, but technically, the recession did start during Bush's term. About 6 weeks or so into his term, but there it is. It is of course, quite ridiculous to blame the start/cause of the recession on Bush seeing the weakness in quite a few indexes in the end of 2000. Throw in the now negative growth in the third quarter of 2000 and things really weren't all that keen. This recession was coming and there was not a damn thing Bush could have done to stop it. Anybody who claims otherwise is drinking kool-aid laced with some really powerful hallucenigenics.
First, he's going to concentrate on prevention. He wants to give everyone access to preventive checkups, and diagnostic screenings to catch disease early, and hold down long term costs.
While this sounds great, one must remember it is based on nothing other than a bromide for the most part. The problem with the above is that it increases the demand for medical resources. This in turn drives up the cost. At the same time if it catches illnesses, injuries, and disease prior to them becoming "expnesive" then it saves money. So the overall effect is ambiguous and Clark is spew bullcrap to claim otherwise.
Now, if you've been adding in your head, you can see that his health care plan alone is going to cost billions of dollars.
These programs always cost far, far more than even the most conservative estimates indicate. Check out just about any social program and the costs are much higher than initially forecasted, especially over long periods of time. One of the problems is that there are usually crappy incentive schemes built in. Take for example the "preventative care measure" Clark has boasted about. One problem is you could get lots of people who have the sniffles showing up and taking up the time of a nurse, doctor and the various admin. people who process patients. If the incentives are structured right you could end up spending much, much more than you ever save. The problem is that the dis-incentives are things like longer lines, crappy service, etc. The idea is to weed out those who are sick from those who aren't ("Oh, I don't feel so bad I want to sit here for 1-2 hours!").
Posted by: Steve on December 22, 2003 2:06 AMOne issue that concerns me about any scheme that would suddenly enroll millions of people in health insurance is whether the capability exists for the insurance companies to write such a massive number of policies overnight. Correct me if I'm wrong, but aren't insurance companies required to maintain a certain ratio of assets to potential liabilities? What if they don't have the assets to write such a huge number of new policies?
If such is the case, simple economics tells us that a vast and sudden increase in demand will result in a vast and sudden increase in the price, and any attempts at price controls will just perpetuate the scarcity.
At such a point, the very people who clamored so loudly for the health insurance scheme will decry the situation as an example of a failure of the free market system, and will use the crisis they provoked as a justification for socialized medicine, which really was their goal all along.
Posted by: TC on December 22, 2003 10:17 AM"Yep, 2% of taxpayers, those Mr. Clark wants to raise taxes on, paid 41% of all taxes collected."
I'm as anti-tax as almost anybody, but I think that when people make this argument, they should also point out what percentage of national income the 2% earned during the same period.
If I'm doing the math right, which I'm probably not, it looks like the over $200k crowd earned just over 22% of the total national income. Based on that, paying 41% of the income tax seems plenty high enough, I agree.
Posted by: J Mann on December 22, 2003 11:26 AMThe economic "recovery" is being pushed by Bush's tax cuts? Bullshit. This recovery (and It IS lagging in job creation) is being paid for by monstrous deficit spending that, if unabated, will amount to an $800 billion per year deficit within three years. The effect on the dollar, on interest rates, on all phases of the economy, will be nothing short of catastrophic. BTW, the 2% who pay 41% of taxes figure without a computation of how much national wealth they control tells us nothing. And for those of you who don't think 44 million Americans being without health insurance is already a drain on the economy (since hospitals have to charge insured people more in order to cover the uninsured) you're just deluded. (And if you haven't checked out the cost of diagnostic, preventive procedures lately, I suggest you do so.) Hey, but who gives a rat's ass about those uninsured people right? They're just mainly kids, poor whites, urban blacks, and Hispanics. Screw 'em. They don't vote Republican anyway.
Posted by: Joe on December 22, 2003 1:08 PMCan I point something out... some healthcare coverage would be better than none. The problem with the current system is that there are lots of people that
a) can't afford healthcare
b) rely on their jobs for healthcare, which doesn't usually provide much choice
c) are never provided any at all (lots of poor children with parents that don't know of the available services)
Now I think forcing everyone into this system is a bad idea. However, giving everyone a minimum level of care isn't such a bad idea.
Posted by: Mike on December 22, 2003 1:55 PMSir,
We share much in our viewpoints. I am a Christian conservative practicing family medicine in Texas.
I served 23 years in the US Army, 14 of those years as a Physician Assistant. I have been retired from the army for about 10 years.
Your characterization of military PA's as inept bungling idiots is both unfair and incorrect. Your perception of military health care is jaundiced to say the least. I suspect that it merely serves as a whipping boy for your attack on Clark.
Let me be very clear. I will support GW as I've supported him and his father in the past. I would not vote for Clark or any other Democrat.
Facts:
Physician Assistants deliver the same quality of care as physicians. Numerous studies confirm this.
Military Physician Assistants consistently score in the top tenth percentile of the NCCPA certification tests.
Military PA's are in tremendous demand in the civilian marketplace because of their advanced training,trauma skills, and overall higher level of autonomous practice.
I served 23 years in the service of my country because of my love of country. Duty, honor, and country really do mean something to some of us.
I personally am deeply insulted for myself and for my compatriots in arms who risked and continue to risk their lives for a concept which allows folks like you to trash them here. How dare you imply that I or any other military PA spent years in the service of our country because we were somehow substandard...
For shame sir...for shame.
Steve Stallings PA-C
USA Ret,
Bremond, Texas
Hilzoy, if you've read my entire post, then you know that I've researched Clark's healthcare program thoroughly, using his own website. My post was not based on one throwaway line.
Suijuris, my point was that the military model has some major drawbacks as a model for general healthcare. The multiple comments by other vets and their dependents backs it up. Are you saying that support of the military must include blanket approval of every activity? Sorry, but the world is more complex than that.
Joe, job creation always lags economic recovery. That's not a sign of things going wrong, but a sign that the recovery is proceeding normally. The deficit is a result of the tax cuts, combined with increased spending for the war, and on social programs. Personally, I don't liek deficits, but there are some occasions where it is required. Wartime is one of them. Oddly, liberals have long preached the value of deficit spending as aa means of igniting an economy. Apparently, it's only bad when republicans do it.
Mr. Stallings, I apologize for giving you offense; as I pointed out, there are some who remain in the military health corps out of honor, loyalty, and a sense of duty, and it is clear that you are one of those.
Posted by: rich on December 22, 2003 7:27 PMWhile I agree with your comments about Clark I take strong exception to your comments about military medicine. My family and me have received military medical care for the past 40 years, both as active duty and a retiree, and it has been exceptional in almost every instance. I would like to address each comment you put out there. NO choice of doctor - I have been in the family practice clinic at ft Belvoir, VA and have had the same doctor the past 12 years prior to that I never had a doctor for less than 6 years. Complete coverage for primary member limited for dependents and retirees - My wife was operated on for cancer 27 years ago at a military hospital in Germany and remains cancer free till this day. My 2 children were born in military hospitals and both they and my wife have been hospitalized and operated on since I have retired. All of these were successful. Tons of red tape - This is almost comical when you analyze it. My wife and I have friends and colleagues using HMO's who have ten times the red tape we have ever seen with military medicine. Most services provided by Nurses or PA's - In 40 years I have seen a physician's assistant once when there was a shortage of doctor's due to a flu outbreak. Required treatments may not be available - Never had this experience in 40 years. Care ranges from adequate to sub-par - I have never experienced sub-par care for my wife, my children or myself. Our current physician is a Colonel whose main job is a hospital administrator, after he finshes his 8 hour workday he sees patients on his own time for 3-4 hours daily and volunteers at a military retirement home on weekends. He is exceptionally dedicated and the best doctor I have ever known. Physician pay significantly below average - In recent years incentive pay has helped this problem. I would like to add one other remark and that is that my wife and me frequently muse that we are fortunate to receive miltary medical care. We are not limted by an HMO which controls the number and costs of tests we may need. We speak to our doctor as long as we need him and we have access to him by phone. Over the years we have heard far more horror stories out of civilian hospitals than we have ever heard from miltary hospitals. There is a stereotype created by postings such as yours which perpetuates a myth having little resemblance to the truth.
Posted by: Ron Slakie on December 23, 2003 3:54 PM"Facts:
Physician Assistants deliver the same quality of care as physicians. Numerous studies confirm this."
Perhaps the poster would care to share those studies? How was quality being defined? Were these outcome studies? In what specific fields of medicine were these studies carried out? In what practice settings were these studies carried out? Were they dealing with specific disease groups? Specific patient subsets? Is the point that PA's rendered equally appropriate or equally sloppy medicine on the primary care level? (I have to assume that these studies are based on primary care issues, as to make such claims for specialty level medicine is beyond absurd) The questions never stop.
Having said that, I agree that horror stories about such and such PA, or so and so doctor or nurse are too eaasily trotted out to make a point- not that I disagree with Rich's analysis of Clark's harebrained scheme to "reform" our medical system.
Furthermore, The poster's contention that military trained PA's are in high demand is true. They are superbly disciplined and very focused. It's been my privilge to work with a number of them in my career. My last two nurses have also come out of the military and have easily been among the best I've encountered.
I just have to chime in on the military health benefits. My husband just retired after 21+ years in the Navy, and I have worked in health care on and off for the last 15 years.
In the 10 years I've been married to him, my experiences with Navy medical have always been either excellent, or just crying out for a malpractice suit. When I was pregnant with our second child, they would not CHAMPUS me out as I was "high risk" (over 35, no other risk factors). This meant that I didn't actually see a board certified OB till my 4th or 5th visit, into the second trimester. I only saw one doctor more than once, and I only saw her twice. They never did a urine sugar check, which all the civilian OBs do every visit, however they did test me for sickle cell anemia. Let's just say that my genetic background (anglo-saxon/celtic) makes it extremely unlikely that I have it, and as I was over 35, if I did, it probably would have been diagnosed well before then.
Portsmouth Naval Hospital tried to kill my 5 month old daughter, sending her home with Rota virus, while she was still vomiting. "As long as she's taking in more than she's losing, she'll be fine". They wouldn't listen to me when I pointed out that the only fluids she wasn't losing were the IV which they had just discontinued. The attitude was that they were the doctors and they knew best; I didn't know anything, inspite of being older than most of them, having many more years of college education than most of them, and coming from a medical family background. 12 hours later I was back with a baby sicker than she had been the first time they admitted her. Being able to say "I told you so" is no comfort in that sort of situation. I had to sit in the ER for over an hour until their pediatric clinic opened, because the ER, inspite of the fact that they accept general ambulance call, had no one who had a clue about infants.
They only treated a friend (a navy widow) for her kidney infection on her fourth or fifth visit (at which point she needed to be hospitalized for 3 days), and the only reason they did'nt ignore here was that her fiance, a marine E-8, informed them that they were going to give her appropriate medical treatment, and a Marine E-8 can cow a Navy lieutenant quite well, thank God.
I have been routinely treated as a complete idiot by navy doctors and nurses; when I was in the ER with a kidney infection, while the treatment was appropriate and timely, they never bothered to tell me what was wrong, since I wouldn't understand. I had to wait till I left, and could read my paperwork.
We had neighbors here in Connecticut who are looking at $30K in medical bills for chemotherapy, because it wasn't approved. (!) I don't know anyone who undergoes chemo for fun, and it isn't an option here in Groton to have this done at the military facility.
The largest OB practice at the base's prefered hospital has stopped accepting Tricare, because the reimbursement rates make Medicaid look really good, and they would like to be able to keep the practice open. Two years ago there were only two orthopedic surgeons in the entire state of CT who accepted Tricare, and at least one of them was dropping it for the similar reasons. Most of the physicians I know here say they would rather deal with a charity case than Tricare, because at least with charity you don't have to waste staff time and money trying to get them to pay.
Yes, there are some fantastic doctors in the military system (the OB I got to see twice was one of them), but there are far too many who would never be able to keep practicing in the civilian world. We don't all get to go to Bethesda or Walter Reed.
I've also lived in Ireland for 8 years, and dealt with their nationalized system. Anyone who says we'd be better off with either of these health care delivery models needs to have his/her head examined (preferably after separating it from the neck).
Posted by: LibraryGryffon on December 24, 2003 12:35 PMClark never said he was going to give everyone military style health care.
His health care plan "will give those without access to job-based coverage the chance to purchase insurance through the same system that covers Members of the United States Congress."
If you're pro-Bush or want to be against Clark, fine. But please base your arguments in fact.
Hmmm...
Looks like the only people who visit this blog are Republicans - wealthy Republicans - who have never had to miss meals to pay for their children's health care insurance.
We have GOT to do something to make health care coverage more affordable or this country is sunk.
NKB
Posted by: NKB on December 30, 2003 1:17 PMPay Attention,
I was paying atention. Clark specified in his speech in Knoxville that he wanted to give everybody access to the same health care he had in the military. I'm just taking him at his word.
NKB, be careful, your prejudice is showing. I am neither rich, nor republican. You're guilty of the same mistake most people make when talking about this issue.
"We have GOT to do something to make health care coverage more affordable..." The assumption inherent in that statement is that health care by nature is too expensive for folks to be able to manage on their own.
That's simply wrong. health care costs didn't start ballooning until health insurance became common, and that didn't happen until Roosevelt's New Deal forced business owners to find new ways to compensate employees due to wage controls.
Access to basic health care (not health care coverage) should be affordable for everyone. health insurance plus malpractice insurance are the two factors behind the explosion in medical costs. Getting rid of them will reduce costs back to a reasonable level. Adding gov't bureaucrats on top of the parasitic insurance salesman and bottom feeding trial lawyers will only insure the complete collapse of the health care system.
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