About five or ten seconds of interview clipped out of a much longer one.. And you have to suspect it's Breitbarted -- cut to make it say what they want.
Look, here's where I got suspicious about the whole thing. Palmisano says he can cut $900 billion of fraud from the health care system. Even assuming he's talking about all of the privately insured health care as well as all of the publicly insured, something is seriously whacky here. The outside estimate for fraud in Medicare plus Medicaid, by industry experts, not the government, is around $60 billion. And the organization most knowledgeable about it (and most likely to inflate the number), the National Health Care Anti-Fraud Association (NHCAA), says it's as high as $100 billion for the whole US health care system, private and public combined.
Why would Palmisano say something like that if he is "serious," as the conspiracy theorists on Fox said?
Well, if you watched the WSJ video, you saw something else: Palisano was now talking about saving $200 billion in fraud, and the other $700 billion was unspecified -- although part of it apparently involved requiring discounts from pharma companies. That's illegal for the federal government to do under present law. Then, when asked by WSJ why it didn't fly, he says that it "didn't align with the administration's priorities." At that time, the priority was to extend health care to everyone.
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My feeling is that IBM's proposal included a lot of things that are unstated here, or you couldn't get anywhere near $900 billion. It may be that they would require new legislation, such as changing the law for negotiating with pharma companies. And the government already had a full load of health care legislation on their plate.
And in my gut, I think the administration didn't believe them. You know I spent some years working in health care writing and promotion. *I* don't believe them when they say they can save $900 billion. That's 1/3 of the total costs of all US health care. If they had something like that, the WSJ would have it in 70-point screaming type on the front page, not buried in a business video.
Pay for what? You're wading into a deep subject there. If you want the perspective of an independent policy institute on what it will cost, here's a good one:
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Too bad. The more times I listen to it, the more I realize Palisano doesn't know what he's talking about. He says it would require "no legislative changes." When the WSJ pointed out to him that his discount idea had been squashed in Congress by the pharmaceutical companies, his response was, "then use IBM's discount." He doesn't seem to understand that the whole idea was outlawed for the government. He really seemed surprised when the WSJ interviewer told him about it. I think maybe Palisano is a big talker...
Palisano is vague about it in the WSJ video.
Wait a minute. You may not be following what's going on here. Be patient for a minute.
These are rough figures I'm pulling from memory, but they're in the ballpark. We spend about $2.7 trillion on health care. Over half of that is government paying for the insurance, as it has been for some years. That's Medicare, Medicaid, VA health care, government employees' health care at all levels, and the Children's Health Insurance Program (CHIP).
Around 1/3 is private insurance, mostly company sponsored or company paid.
The rest is uninsured. Some small percentage of this is paid out of the pockets of private individuals. But the big bills, and many of the small bills, are paid by our taxes. That's the Gunner types for the big bills, and the uninsured poor visiting emergency rooms for the small ones. It's expensive as hell and the outcomes are poor because there is no preventive care for those people, and the chronic care is almost nonexistent, except as a new "emergency" each time they go to the ER. It's based on systems made for handling emergencies, and every sore throat gets the ER treatment.
So we're paying for it already. And we're paying much more than we would if it was all under one program, with preventive and continuing care available for everyone.
Obama's program is all about getting it all under that roof, while not interfering with private programs that people are happy with and want to keep. This has the benefits implied above, plus it puts big-time pricing power into the equation to control costs -- eventually, if the Republicans will go along with it. There are lots of plans for controlling costs out there, besides IBM's, but there is no authority able to put them into action.
And the political will is weak. My son interned with the guy who wrote Medicare Part D. He's a Republican, then Staff Director of the House Ways and Means Health Subcommittee. He says the plan originally was to allow Medicare to negotiate, but he wasn't allowed to write it into the bill. It's a long story. That guy now runs a health care lobbying firm, BTW.
So, do you see the picture? We're already paying for it and we have been for years. We're paying more than we should have to. The PPACA (the health care reform act) has some costs that go up and down, but the point is to start going down as soon as possible.
Again, we'll be paying for no more than we're paying now. That's the only way to really get costs under control. And, at the same time (and the real motivator for most of the advocates), to simultaneously clean up the act, getting ordinary medical care out of the ERs and improving preventive and chronic care.
The OMB has made forecasts that contradict much of what the Tea Partiers are saying -- because the teabaggers generally don't know what they're talking about, and those that do are spinning it all to hell for philosophical reasons rather than fiscal ones.
That think tank I pointed to above, the Urban Institute, has studied a lot of the questions surrounding health care in general and the PPACA in particular. They write abstracts so you can get the bottom line in a paragraph or two:
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Don't listen to the blowhards who are running for office. Don't listen to the teabag ignoramuses. Read some independent analysis.
Actually, thi yet another chain email, has to do more with Republicans' gullibility (for those gullible ones who have not verified the veracity of that chain e-mail), or lack of honesty (for those who have verified it, but dishonestly reposted it anyway).
This is a perfect example of what I mentioned -- Republicans spreading lies via false chain e-mails. This had a lot to do with me losing trust in the Republican party. I mean, how can I have trust in a party of liars and suckers?
The rule of thumb is very simple: if you receive a pro-Republican chain email, chances are great that it is a lie. Reposting it without triple checking is hazardous to your reputation.
If those emails were not lies, they would appear in more reputable sources instead of emails.
All you need to do so is visit any of the fact checking websites.
The more I look into this, the more skeptical I am about what it is that IBM was proposing. The whole idea seems to have dropped off the planet. Palisano's numbers look ridiculous.
I wish I was still in the business and could afford the time to track it down. I'd be on the phone with IBM's media people tomorrow morning.
Man, IBM's press office is quick to respond. I have the story. I am not going to repeat it in public, nor in e-mail.. If you want the whole thing, I'll send you my phone number and we can discuss it.
What I will say, though, is that Fox screwed this one up royally. The Wall Street Journal really dropped the ball. And the bloggers are misleading, unethical, and irresponsible -- but we knew that already.
The bottom line is that the savings was projected to be $200 billion over ten years, distributed between Medicare, Medicaid, food stamps, federal grants, and income tax refunds. Yes, that's right. The $900 billion is also projected over ten years, and includes ALL federal government activities, plus things like selling off thousands of government buildings and leasing them back, and increasing government fees wherever possible.
So Mr. Palisano misspoke a bit. More than a bit. And the WSJ and Fox turned it all on its head.
If you want to read the report he was basing it on, it's here:
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What a screw-up, huh?
(Why, oh why, did the WSJ, US News and World Report, and Fox News not do what I just did? I'll have to reprimand them when I see them...)
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