August 26, 2009 in Opinion

Smart Bombs: Maintenance required soon

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If cable news and talk radio were national parks, they’d be Yellowstone. Myriad pools of boiling anger that constantly hiss and vent. Stinks, too. On the trip back from a recent vacation, we took the gorgeous route between West Yellowstone and Bozeman that snakes through the Gallatin Mountains. As we hit little Big Sky, a warning sign flashed on my Toyota’s console: “Maintenance Req’d Soon.”

Yeah, that’s what you want to read in the middle of Montana. As luck would have it, I happened upon a Toyota dealership in Belgrade, where President Obama would land a couple of hours later to listen to hissing and venting at a town hall session on health care. As for us, we were well on our way to Missoula after a mechanic pointed out that our warning mechanism wasn’t reset after our recent service. In short, the car was fine.

If only it were that easy to reset the health care debate, which has veered seriously off track. Actually, it was never on track, because the focus has been on universal coverage and the proper way to deliver it, not on cost containment. This is like spin-balancing a set of bald tires.

Too much health care. Suddenly the people who used to be in charge of the country are very concerned about health care costs. What did they do about that when they had a chance? Nothing. Obama and Democratic leaders in Congress will join that group if they don’t get a handle on costs. They know this. They’ve seen or heard about the reports from the Dartmouth University researchers who have studied the wide disparity in health care costs in this nation. The leading factor in the kind of care you will receive is where you live. It ought to be based on scientific evidence that treatment actually is needed and works.

This is documented again and again in Shannon Brownlee’s book “Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer.” The book was published in 2006 and the facts and figures are from then. It’s doubtful much has changed since, except that costs have gone up. A small sampling:

•In Boise, back surgery was 300 percent more likely than in Manhattan. You had a 60 percent greater chance of back surgery if you moved from Tampa to Fort Myers, Fla.

•Arthroscopic surgery – later found to be ineffective for arthritic knees – was five times more likely to be performed in Miami than Iowa City.

•One of the Dartmouth researchers’ mothers was in very poor health and not expected to live much longer. Before her death, doctors ordered up a mammogram. There was no discussion about what would happen if she did have cancer. Treat her, even though she didn’t have long to live? They also tested her for cataracts. When she eventually collapsed at home, they tried heroic measures to revive her there and at the emergency room, even though she made it clear that she didn’t want that.

•Doctors in hospitals affiliated with Harvard Medical School were four times more likely to admit patients to intensive care units than their counterparts at Yale. Dr. Jack Wennberg of Dartmouth, who has made it his life’s work to point out the spending insanity in health care, drove home this point at a conference where he explained the different rates of ICU admittance between New Haven, Conn. (home of Yale), and Boston (near Harvard). Before presenting the stunning disparity, he deliberately switched the labels on the slides. The doctors from Boston smugly offered damning reasons why their counterparts from New Haven were so eager to fill up the ICU. Then Wennberg announced that he “goofed” and switched the labels back. Now the Boston doctors were saddled with their own explanations, and the New Haven doctors were secure in the knowledge that their more conservative and less expensive approach did not harm their patients.

Much venting and hissing ensued.

What’s clear from the current health care debate is that nobody in power wants to touch the issue of overtreatment. The system will remain sick until we do.

Smart Bombs, by Associate Editor Gary Crooks, appears Wednesdays and Sundays on the Opinion page. Crooks can be reached at garyc@spokesman.com or (509) 459-5026.

Two comments on this story so far. Add yours!

• 

  Gary D Rhodes on August 26 at 6:24 p.m.

  On Wednesday, August 5th it was announced locally that Obama would be coming here. There are many groups here that are against his healthcare and huge spending so those groups began talking and deciding on what they were going to do. The White House would not release ANY details other than the date.

  They chose to use a hangar at the airport that is the most remotely located hangar. You could not pick a more remote location, and you can not get to it easily. It is totally secluded from the public.
  There are many areas in Belgrade and Bozeman which could have held a large amount of folks with sufficient parking (gymnasiums/auditoriums). All of which have chairs and tables. During the week, cargo by the TONS was being shipped in constantly. Airport employees could not believe how it just kept coming. Though it was Obama coming, several expressed how excessive it was, especially during a recession.

  Late Tuesday/early Wednesday the 12th, they said that tickets would be handed out on Thursday 9am at two locations and the resident would be arriving around 12:30 Friday. Thursday morning about 600 tickets were passed out. However, 1500 were printed at a Local printing shop per White House request. Hmmmm……900 tickets just DISAPPEARED.

  This same morning someone called into the radio from the local UPS branch and said that THOUSANDS of Dollars of Lobster were shipped in for Obama. Montana has some of the best beef in the nation!!! And it ould have been really wonderful to help out the local economy. Anyone heard of the Recession?? Just think…with all of the traveling the White House is doing. One can only imagine what else we are paying for.

  The groups that wanted to protest Obama’s spending and healthcare had gotten a permit to protest and that area was roped off. But that was not to be. A large bus carrying Service Employees International Union (SEIU) members drove up onto the area (illegal) and unloaded right there. It was quite a commotion and there were specifically 2 SEIU men trying to make trouble and start a fight. Police did get involved and arrested the one man but they said they did not have the manpower to remove the SEIU crowd. The SEIU crowd was very organized and young. About 99% were under the age of 30 and they were not locals! They had bullhorns and PROFESSIONALLY made signs. Some even wore preprinted T-shirts. Oh, and Planned Parenthood folks were with them…..professing abortion rights with their T-shirts and preprinted signs. (BTW, all these folks did have a permit to protest in ANOTHER area)

  Those against healthcare/spending moved away from the SEIU crowd to avoid confrontation. They were orderly and respectful. Even though SEIU kept coming over and walking through, continuing to be very intimidating and aggressive at the direction of the one SEIU man.

  So we had Montana folks from ALL OVER the state with their homemade signs and their DOGS with homemade signs. We had cowboys, nurses, doctors you name it. There was even a guy from Texas who had been driving through. He found out about the occasion, went to the store, made a sign, and came to protest. If you are wondering about the press…..Well, all of the major networks were over by that remote hangar I mentioned. They were conveniently parked on the other side of the buildings FAR away. None of these crowds were even visible to them. I have my doubts that they knew anything about the crowds. We did have some local news media around us from this state and Idaho.

  Speaking of the local media…they were invited. However, all questions were to be turned into the White House in advance of the event.
  I am very dismayed about what I learned about our current White House. The amount of control and manipulation was unbelievable. I felt I was not living in the United States of America, more like the USSR!!.

• 

  Gary D Rhodes on August 26 at 7:50 p.m.

  http://theobamafile.com/ObamaLatest.htm