The Illegitimate President

Following are excerpts from Mr. Obama’s recent speech to the AMA, followd by translations of those quotes.

From the moment I took office as President, the central challenge we have confronted as a nation has been the need to lift ourselves out of the worst recession since World War II. In recent months, we have taken a series of extraordinary steps, not just to repair the immediate damage to our economy, but to build a new foundation for lasting and sustained growth. We are creating new jobs. We are unfreezing our credit markets. And we are stemming the loss of homes and the decline of home values.

We are not actually doing any of those things, but I like to say we are.

But even as we have made progress, we know that the road to prosperity remains long and difficult. We also know that one essential step on our journey is to control the spiraling cost of health care in America.

Government regulation and interference has made healthcare more expensive for everyone except illegal immigrants.

Today, we are spending over $2 trillion a year on health care – almost 50% more per person than the next most costly nation. And yet, for all this spending, more of our citizens are uninsured; the quality of our care is often lower; and we aren’t any healthier. In fact, citizens in some countries that spend less than we do are actually living longer than we do.

Government programs, like Medicare and Medicade, are tremendously inefficient, just like Fannie Mae and Freddie Mac, and waste trillions of dollars and will soon consume the entire federal budget. And despite how government programs drive down the quality of care, there is no correlation between healthcare in this nation and the lifespan of people living here and in other countries.

Make no mistake: the cost of our health care is a threat to our economy. It is an escalating burden on our families and businesses. It is a ticking time-bomb for the federal budget. And it is unsustainable for the United States of America.

… did he just admit that the programs are unsustainable?

It is unsustainable for Americans like Laura Klitzka, a young mother I met in Wisconsin last week, who has learned that the breast cancer she thought she’d beaten had spread to her bones; who is now being forced to spend time worrying about how to cover the $50,000 in medical debts she has already accumulated, when all she wants to do is spend time with her two children and focus on getting well. These are not worries a woman like Laura should have to face in a nation as wealthy as ours.

Stories like Laura’s are being told by women and men all across this country – by families who have seen out-of-pocket costs soar, and premiums double over the last decade at a rate three times faster than wages. This is forcing Americans of all ages to go without the checkups or prescriptions they need. It’s creating a situation where a single illness can wipe out a lifetime of savings.

Government has forced people to use health insurance in a manner completely opposite to how insurance is intended to run.  Stories like Laura’s are being told by women and men all across the country – they use insurance to subsudize higher costs for healthcare and medicines and routine checkups, like using your car insurance to pay for oil changes, tire rotations, and tune-ups, instead of just for accidents.  This drives up the cost of healthcare for everyone, and allows pharmacies and medical corporatoins to charge much higher rates than they normally could, because they receive your co-pay in addition to the insurance reimbursement.

Our costly health care system is unsustainable for doctors like Michael Kahn in New Hampshire, who, as he puts it, spends 20% of each day supervising a staff explaining insurance problems to patients, completing authorization forms, and writing appeal letters; a routine that he calls disruptive and distracting, giving him less time to do what he became a doctor to do and actually care for his patients.

Government red-tape forces individual practitioners to spend an inordinate amount of time on paperwork, which tends to put them out of business because they cannot work and earn salaries for themselves and their staff while doing paperwork.  Hospitals and healthcare organizations can afford to have staff dedicated to doing paperwork.

Small business owners like Chris and Becky Link in Nashville are also struggling. They’ve always wanted to do right by the workers at their family-run marketing firm, but have recently had to do the unthinkable and lay off a number of employees – layoffs that could have been deferred, they say, if health care costs weren’t so high. Across the country, over one third of small businesses have reduced benefits in recent years and one third have dropped their workers’ coverage altogether since the early 90′s.

And we hope to increase occurences like this by making healthcare mandatory, taxable, and more expensive!

Our largest companies are suffering as well. A big part of what led General Motors and Chrysler into trouble in recent decades were the huge costs they racked up providing health care for their workers; costs that made them less profitable, and less competitive with automakers around the world. If we do not fix our health care system, America may go the way of GM; paying more, getting less, and going broke.

And if you can believe it, we (the federal government) personally intervened to prevent GM from declaring bankruptcy by propping them up with billions of now lost taxpayer dollars, to prevent them from being able to renegotiate those costs!!  And if you’ve read any news, you know that I, Obama, am telling the government ot pay more, earn less, and go broke!!

When it comes to the cost of our health care, then, the status quo is unsustainable. Reform is not a luxury, but a necessity. I know there has been much discussion about what reform would cost, and rightly so. This is a test of whether we – Democrats and Republicans alike – are serious about holding the line on new spending and restoring fiscal discipline.

And by “reform,” I mean doing more of what doesn’t work and running the economy into the ground, no matter what!

But let there be no doubt – the cost of inaction is greater. If we fail to act, premiums will climb higher, benefits will erode further, and the rolls of uninsured will swell to include millions more Americans.

If we fail to act, one out of every five dollars we earn will be spent on health care within a decade. In thirty years, it will be about one out of every three – a trend that will mean lost jobs, lower take-home pay, shuttered businesses, and a lower standard of living for all Americans.

If we fail to act, healthcare will be WAY cheaper than what I’m now about to propose.

And if we fail to act, federal spending on Medicaid and Medicare will grow over the coming decades by an amount almost equal to the amount our government currently spends on our nation’s defense. In fact, it will eventually grow larger than what our government spends on anything else today. It’s a scenario that will swamp our federal and state budgets, and impose a vicious choice of either unprecedented tax hikes, overwhelming deficits, or drastic cuts in our federal and state budgets.

Why wait decades to blow the budget when we can do it in years!

To say it as plainly as I can, health care reform is the single most important thing we can do for America’s long-term fiscal health. That is a fact.

No matter what you want, I’m going to shove more government regulation, intrusion into your privacy, and unbelievably large wads of federal debt down your throat.  That is a fact.

And yet, as clear as it is that our system badly needs reform, reform is not inevitable. There’s a sense out there among some that, as bad as our current system may be, the devil we know is better than the devil we don’t. There is a fear of change – a worry that we may lose what works about our health care system while trying to fix what doesn’t.

I understand that fear. I understand that cynicism. They are scars left over from past efforts at reform. Presidents have called for health care reform for nearly a century. Teddy Roosevelt called for it. Harry Truman called for it. Richard Nixon called for it. Jimmy Carter called for it. Bill Clinton called for it. But while significant individual reforms have been made – such as Medicare, Medicaid, and the children’s health insurance program – efforts at comprehensive reform that covers everyone and brings down costs have largely failed.

You’re right — government intervention always makes things worse.  But that doesn’t mean we can’t lie and claim we’ll fix it and then make it worse again, right?

Part of the reason is because the different groups involved – physicians, insurance companies, businesses, workers, and others – simply couldn’t agree on the need for reform or what shape it would take. And another part of the reason has been the fierce opposition fueled by some interest groups and lobbyists – opposition that has used fear tactics to paint any effort to achieve reform as an attempt to socialize medicine.

The people who actually deliver healthcare have always disagreed with government methods to socialize healthcare because it is always more wasteful, expensive, intrusive, and inefficient than the free market.

Despite this long history of failure, I am standing here today because I think we are in a different time. One sign that things are different is that just this past week, the Senate passed a bill that will protect children from the dangers of smoking – a reform the AMA has long championed – and one that went nowhere when it was proposed a decade ago. What makes this moment different is that this time – for the first time – key stakeholders are aligning not against, but in favor of reform. They are coming together out of a recognition that while reform will take everyone in our health care community doing their part, ultimately, everyone will benefit.

For some reason, an unbelievable number of gullible morons put me into office despite my suppressing any evidence of whether or not I’m even qualified to be President!  The press worships at my feet, and Congress jumps at the opportunity to lick my boots!  We’ve passed more bad legislation and piled more debt on you moronically blind voters, that I bet we can get anything past you guys!!!

That’s what I’ve come to talk about today. We know the moment is right for health care reform. We know this is an historic opportunity we’ve never seen before and may not see again. But we also know that there are those who will try and scuttle this opportunity no matter what – who will use the same scare tactics and fear-mongering that’s worked in the past. They’ll give dire warnings about socialized medicine and government takeovers; long lines and rationed care; decisions made by bureaucrats and not doctors. We’ve heard it all before – and because these fear tactics have worked, things have kept getting worse.

Some people will interpret my agenda for you and tell the truth about how this is going to work — try and ignore all that. (I’m going to skip a few paragraphs of drivel here.)

First, we need to upgrade our medical records by switching from a paper to an electronic system of record keeping. And we have already begun to do this with an investment we made as part of our Recovery Act.

Even though we don’t need to, this is a good way to get you all to waste countless man-hours and get private information where the government can examine it and share it with everyone in Canada and Mexico, regardless of whether you want us to or not, as part of the SPP.

It simply doesn’t make sense that patients in the 21st century are still filling out forms with pens on papers that have to be stored away somewhere. As Newt Gingrich has rightly pointed out, we do a better job tracking a FedEx package in this country than we do tracking a patient’s health records. You shouldn’t have to tell every new doctor you see about your medical history, or what prescriptions you’re taking. You should not have to repeat costly tests. All of that information should be stored securely in a private medical record so that your information can be tracked from one doctor to another – even if you change jobs, even if you move, and even if you have to see a number of different specialists.

We want the government to be able to track you and your history like a FedEx package.

The second step that we can all agree on is to invest more in preventive care so that we can avoid illness and disease in the first place. That starts with each of us taking more responsibility for our health and the health of our children. It means quitting smoking, going in for that mammogram or colon cancer screening. It means going for a run or hitting the gym, and raising our children to step away from the video games and spend more time playing outside.

By partnering the FDA, CDC, and government with Big Pharma, we can madate more medicines and procedures to enrich ourselves at your expense.  Like I said before, we’ve succeeded in banning smoking in more places, and we will continue to mandate what you are allowed to do.  We will be able to make it a condition to receiving healthcare!!

Our federal government also has to step up its efforts to advance the cause of healthy living. Five of the costliest illnesses and conditions – cancer, cardiovascular disease, diabetes, lung disease, and strokes – can be prevented. And yet only a fraction of every health care dollar goes to prevention or public health. That is starting to change with an investment we are making in prevention and wellness programs that can help us avoid diseases that harm our health and the health of our economy.

We’ll mandate what healthcare costs will be spent on, because we control the money, so we’ll be able to try and force you to be healthy, whether you want to or not, or deny you coverage or worse!  And we’ll have your electronic records, you FedEx package you, so we can keep track of how much you’re running, fatty!

Despite what some have suggested, the reason we have these costs is not simply because we have an aging population. Demographics do account for part of rising costs because older, sicker societies pay more on health care than younger, healthier ones. But what accounts for the bulk of our costs is the nature of our health care system itself – a system where we spend vast amounts of money on things that aren’t making our people any healthier; a system that automatically equates more expensive care with better care.

The bulk of our costs is spent complying with government regulation, despite government regulation not inproving the quality of care.

A recent article in the New Yorker, for example, showed how McAllen, Texas is spending twice as much as El Paso County – not because people in McAllen are sicker and not because they are getting better care. They are simply using more treatments – treatments they don’t really need; treatments that, in some cases, can actually do people harm by raising the risk of infection or medical error. And the problem is, this pattern is repeating itself across America. One Dartmouth study showed that you’re no less likely to die from a heart attack and other ailments in a higher spending area than in a lower spending one.

There are two main reasons for this. The first is a system of incentives where the more tests and services are provided, the more money we pay. And a lot of people in this room know what I’m talking about. It is a model that rewards the quantity of care rather than the quality of care; that pushes you, the doctor, to see more and more patients even if you can’t spend much time with each; and gives you every incentive to order that extra MRI or EKG, even if it’s not truly necessary. It is a model that has taken the pursuit of medicine from a profession – a calling – to a business.

And this is entirely due to the regulations and requirements that come from socialized medicine — Medicare, Medicaid, and the insurance industry.  You’re welcome!

And we need to rethink the cost of a medical education, and do more to reward medical students who choose a career as a primary care physicians and who choose to work in underserved areas instead of a more lucrative path. That’s why we are making a substantial investment in the National Health Service Corps that will make medical training more affordable for primary care doctors and nurse practitioners so they aren’t drowning in debt when they enter the workforce.

Maybe we can socialize the schools too, even more than they are now!  And we can pay doctors and control directly, because federal funds always come with federal regulations!

The second structural reform we need to make is to improve the quality of medical information making its way to doctors and patients. We have the best medical schools, the most sophisticated labs, and the most advanced training of any nation on the globe. Yet we are not doing a very good job harnessing our collective knowledge and experience on behalf of better medicine. Less than one percent of our health care spending goes to examining what treatments are most effective. And even when that information finds its way into journals, it can take up to 17 years to find its way to an exam room or operating table.

The Nazi’s were able to experiment directly on the Jews, maybe we can do that with the populace at large!

As a result, too many doctors and patients are making decisions without the benefit of the latest research. A recent study, for example, found that only half of all cardiac guidelines are based on scientific evidence. Half. That means doctors may be doing a bypass operation when placing a stent is equally effective, or placing a stent when adjusting a patient’s drugs and medical management is equally effective – driving up costs without improving a patient’s health.

And with massively and centrally-controlled medicine, we can always recommend the cheapest and least effective treatments in the name of controlling costs.

Let me be clear: identifying what works is not about dictating what kind of care should be provided. It’s about providing patients and doctors with the information they need to make the best medical decisions.

Let me be clear: I want the a federal agency to have absolute say over what procedures you are allowed to perform in exchange for federal funds.

Holy cow his speech is long!  That’s all I can handle for now, maybe I’ll come back to it later.