US Health Care in Sound Bites

“Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health. Millions do not now have protection or security against the economic effects of sickness. The time has arrived for action to help them attain that opportunity and that protection.”

“I usually find that those who are loudest in protesting against medical help by the federal government are those who do not need help.”

“I have had some bitter disappointments as president, but the one that has troubled me most, in a personal way, has been the failure to defeat opposition to a national compulsory health insurance program.”

President Harry S. Truman

 

“We must seize the moment of freedom’s triumph abroad to make America not just a rich society but a good society. The richest country in the world cannot tolerate the fact that we have the highest per capita health care costs in the world and yet 38 million of our people are unable to get adequate medical care because they cannot afford it.”

President Richard M. Nixon

 

“People can go to the state that they want to live in. States have all kinds of different policies and there are disparities among states for many things: driving restrictions, alcohol, whatever. We’re putting choices back in the hands of the states. That’s what Jeffersonian democracy provides for.”

Rep. Robert Pittenger (R-NC)

 

“We are giving people actual freedom.”

House Majority Leader Kevin McCarthy (R-CA)

 

“The only people who have to worry about rising costs under Republicans’ health bill are the very tiny segment of the country that waits until they’re sick to buy insurance.”

Rep. Greg Walden (R-OR)

 

“You can’t compare the rest of the world to us. They do not have the big diverse populations that we have. They do not have the inner-city populations that we have.”

Former Rep. Joe Walsh (R-IL)

 

“My understanding is that it will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, you know, they are doing the things to keep their bodies healthy.”

Rep. Mo Brooks (R-AL)

 

(Refused to comment on his yes vote.)

Rep. Darrell Issa (R-CA)

 

“Nobody dies because they don’t have access to health care.”

Rep. Raul Labrador (R-ID)

 

“A friend of mine was in Scotland recently. He got very, very sick. They took him by ambulance and he was there four days. He was really in trouble, and when they released him and he said, ‘Where do I pay?’ And they said, ‘There’s no charge.’ Not only that, he said it was like great doctors, great care. I mean we could have a great system like that in this country.”

“We’re going to have insurance for everyone.”

“There was a philosophy in some circles that if you can’t pay for it, you don’t get it.  That’s not going to happen with us.  People can expect to have great health care.”

President Donald J. Trump

“Am I doing OK? I’m President! Hey, I’m President! Can you believe it, right?”

 

And in other Republican news…

Minnesota’s state Republican chair apologized Monday to Rep. Keith Ellison (D-MN) for a post on the 7th Congressional District Republican Party’s Facebook page calling the congressman “Minnesota’s Head Muslim Goat Humper.”

ACA and HCA and Cheesecake Factory Medicine

(In what other first-world country do people regularly come together to raise money to help pay a friend or neighbor’s medical bills?)

Put aside for a moment all the headlines about repealing Obamacare and replacing it with Paul Ryan’s handiwork. (You knew he was serious because he presented his PowerPoint overview wearing rolled-up shirtsleeves with not one, but two U.S. flags behind him.) The U.S. spends more, way more, per capita on health care than any other country. The U.S. ranks near the bottom in life expectancy, infant mortality and obesity.

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Atul Gawande, a surgeon at Brigham and Women’s Hospital, in Boston, and a professor in the department of health policy and management at Harvard School of Public Health and in the department of surgery at Harvard Medical School, compared our health care processes and results to the processes and outcomes at the Cheesecake Factory chain of restaurants.

At the Cheesecake Factory, for preparation of Hibachi Steak:

“…the instructions were precise about the ingredients and the objectives (the steak slices were to be a quarter of an inch thick, the presentation just so), but not about how to get there. The cook has to decide how much to salt and baste, how to sequence the onions and mushrooms and meat so they’re done at the same time, how to swivel from grill to countertop and back, sprinkling a pinch of salt here, flipping a burger there, sending word to the fry cook for the asparagus tempura, all the while keeping an eye on the steak. In producing complicated food, there might be recipes, but there was also a substantial amount of what’s called “tacit knowledge”—knowledge that has not been reduced to instructions.”

At the hospital where the author is a surgeon, he gives the example of knee-replacement surgery:

“…there was now, for instance, a limit as to which prostheses they could use. Each of our nine knee-replacement surgeons had his preferred type and brand. Knee surgeons are as particular about their implants as professional tennis players are about their racquets. But the hardware is easily the biggest cost of the operation—the average retail price is around eight thousand dollars, and some cost twice that, with no solid evidence of real differences in results.”

Read Dr. Gawande’s report, published by the New Yorker, here. Definitely will stimulate your thinking.