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August 18, 2009

60,000 Quit AARP, Many Signing Up with "Conservative Alternative" American Seniors Association

A Waterloo, too, for Washington's permanent quasi-governmental lobbyist elite.

CBS News has learned that up to 60,000 people have cancelled their AARP memberships since July 1, angered over the group's position on health care.

Elaine Guardiani has been with AARP for 14 years, and said, "I'm extremely disappointed in AARP."

Retired nurse Dale Anderson has 12 years with AARP and said, "I don't wanna be connected with AARP."

Many are switching to the American Seniors Association, a group that calls itself the conservative alternative as CBS News Investigative Correspondent Sharyl Attkisson reports.

...

The American Seniors Association is flat-out against President Obama's plan, which calls for $313 billion dollars in Medicare cuts over ten years. The AARP is widely viewed as supporting the President.

The article notes that the AARP, while not formally endorsing Obama's plan and cuts, seems to be "waffling" on the issue in the eyes of many, supporting it through deed if not word.

Dick Morris, who -- credit where credit's due -- has been pushing the cuts to seniors as our best line of attack for longer than anyone I know of, crows a bit and says thank God for seniors.

Whether or not he admits it even to himself, Obama's talk of cutting "inefficiencies" and reducing costs translates to less care, of lower quality, for the elderly. Every existing national health system finds ways to deny state-of-the-art medications and necessary surgical procedures to countless patients, and ObamaCare has the nascent mechanisms to do the same. With the limited options that Obama's vision would leave them, many will find that "end of life counseling" necessary and even welcome.

"Reform" would cut care to the elderly in several ways:

* Slash hundreds of billions from Medicare spending, largely by lowering reimbursement rates to doctors and hospitals for patient care.

If a hospital gets less money for each MRI, it will do fewer of them. If a surgeon gets paid less for a heart bypass on a Medicare patient, he'll perform them more rarely. These facts of the marketplace are not only inevitable consequences of Obama's cuts but are also its intended consequence. Without them, his savings will prove illusory.

* Expanding the patient load by extending full coverage to 50 million Americans (including such "Americans" as illegal immigrants) without boosting the supply of care will force rationing decisions on harried and overworked doctors and hospitals.

People with insurance use a lot more health-care resources -- so today's facilities and personnel will have to cope with the increased workload. Busy surgeons will have to decide who would benefit most from their treatment -- de facto rationing. The elderly will, inevitably, be the losers.

* The Federal Health Board, established by this legislation, will be charged with collecting data on various forms of treatment for different conditions to assess which are the most effective and efficient. While the bills don't force providers to obey the board's "guidance," its recommendations will still wind up setting the standards and protocols for care systemwide.

We've already seen Medicare and Medicaid lead a similar race to the bottom with their formularies and other regulations. With Washington dictating what every policy must cover and regulating all rates, insurers and providers will all have to follow the FHB's advice on limiting care to the elderly -- a de facto rationing system.

* In assessing whether to allow certain treatments to a given patient, medical professionals will be encouraged to apply the Quality-Adjusted Remaining Years system. Under QARY, decision-makers seek to "amortize" the cost of treatment over the remaining "quality years of life" likely for that patient.

Imagine a hip replacement costing $100,000 and the 75-year-old who needs it, a diabetic with a heart condition deemed to have just three "quality" years left. That works out to $33,333 a year -- too steep! Surgery disallowed! (Unless of course, the patient has political connections . . . )

Younger, healthier patients would still get the surgery, of course. The QARY system simply aims to deny health care to the oldest and most infirm, "scientifically" condemning them to infirmity, pain and earlier death than would otherwise be their fate.

In short, ObamaCare doesn't need to set up "death panels" to make retail decisions about ending the lives of individual patients. The whole "reform" scheme is one giant death panel in its own right.

Through the eighties and nineties, Republicans would sometimes propose limiting Medicare and Medicaid (increased co-pays, etc.) and every time the Democratic war room accused them of trying to kill Grandma.

Suddenly, the media-Democratic establishment finds such rhetoric to be beyond the pale. What Terry MacCauliffe, Harry Reid, and Tom Daschle said without media objection one hundred times is suddenly the most toxic and dishonest thing ever said in the history of saying stuff, when Sarah Palin writes it once.

It should also be noted that the Republican plans were concerned with keeping the system solvent and therefore alive. Obama is right -- but then, so is everybody -- when he says the system will become insolvent without reforms.

True, true. But what he proposes is entirely unresponsive to that observation. Rather than making the system self-sustaining and solvent, he proposes instead to flood the government-health-care-system with upwards of 50 million new enrollees, quite a few of them not even American, and will raise taxes and cut benefits from seniors to make this scheme (supposedly) close to "deficit neutral."

But even if it were "deficit neutral," it would still become insolvent -- as Obama says, without reducing the costs, the system is guaranteed to go broke.

So I don't quite understand how merely making it "deficit neutral" will improve the situation.

All I see is Obama taking health care from some people to give it to others.

A case could be made, of course, that to the extent we have a socialized subsystem for health care, we're misallocating resources, paying quite a bit for the elderly and not so much for, say, a premature baby.

One could make that case. But one would almost certainly lose on it, as seniors vote in large numbers and are understandably reluctant, as anyone would be, to lower their own standard of care to benefit someone else.

And because Obama knows he'd lose on that argument, honestly stated, he simply lies about it and assures seniors that his $500 billion in Medicaid/Medicare costs will all be achieved through improved "efficiency."

No one believes that. We all share, I think, an understanding that whatever system we're talking about, its inefficiencies are either hard-wired into the system (often due to politics) and difficult to undo or modify, or else aren't really "inefficiencies" at all. I'm not at all sure, for example, it's "inefficient" to remove a kid's tonsils if he has perpetual infections, nor that it's always "wasteful" to conduct multiple tests when diagnosing an illness.

At most, even with fairly heroic measures and politically-gutsy changes, a system -- particularly a government system -- is going to become, at the very most, maybe 5% more efficient. Tops.

Apart from reducing predatory tonsillectomies and entrepreneurial maimings by our Saw-fan surgeons, Obama's pretty damn vague about where he sees these bountiful new efficiencies emerging.

Oh, right. If we all get in great shape we'll save the system billions. Kinda. We'll save the system a bit of money as our death-spiral of declining health is put off a few years, and then we'll go through the same costly end-of-life hospitalizations as those who are less healthy. Same costs, just delayed five or six years. The savings here are only the interest on a cost delayed by a short time.

There are a huge number of reasons to lead a healthy lifestyle -- including attracting a mate, feeling good and strong, living to see your kids graduate high school, etc. -- and many of us do not respond to such tangible, crucial incentives.

And yet I'm to believe that an abstract interest in keeping the federal budget deficit down is going to cause someone to think, "Maybe I should look into quitting smoking" or "Maybe I should drop the 80 pounds I've put on since my twenties."

No sale. The cuts will include a pittance of arguably "wasteful" costs, but the bulk will either 1) cut into actual health services or, more likely, 2) won't be made at all, thus blowing up the deficit as Obama simply provides all the health care we're already obligated to provide but cannot afford and adds to that strained system 50 million more needy souls.


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posted by Ace at 11:16 AM

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