07 March 2009

The least surprising thing I've read today

Via Scanman:
GE, Siemens Fight Obama Plan to Cut MRI, X-Ray Costs

March 6 (Bloomberg) -- General Electric Co. and Siemens AG, the biggest makers of medical imaging machines, say President Barack Obama’s plan to slash spending on the use of MRIs and X-rays threatens patients, and they’ll lobby Congress to block it. 

I'm astonished.   Wait, no, that's not the right word.   What's that thing that's the opposite of surprise?   Never mind, it'll come to me later.   The next thing you'll be telling me is that PhRMA is going to opposed Obama's proposal to cut prices of prescription drugs.   What?  That already happened?   Who'd have thunk it?  (In fairness, Tauzin has also made conciliatory noises, too.)

This is by far going to be the hardest part of health care reform.  There's a multi-trillion pile of dollars on the table, and every single interest group is very very interested in maximizing their share of the pile.   The AMA will argue for increased medicare and medicaid reimbursement.   The nurses associations are requesting increased investment in nursing resources.  The insurance lobby is trying to tilt the table in favor of insurers.   In short, any organization that can make a half-way reasonable case for it will opportunistically demand higher levels of funding, and any interest that winds up on the de-funding list will scream to high heaven and work like hell to stop it.  And we haven't even gotten to the internecine warfare of primary care doctors vs specialists!

The advantage of comprehensive reform is the "blank slate" opportunity to make sweeping, fundamental change.   The risk is that the process is such a free-for-all, so chaotic, that it's hard to predict what the final product will actually look like, once the hard decisions are made in the mileu of all the horse-trading, uneasy bedfellows, and shifting alliances. 


  1. I had to chuckle. What a surprise they they object. haha. It shouldn't be a surprise that each special interest group (and that includes doctors too) will be opposed to any change in their money stream with health care reform.

  2. Thanks for the mention Shadowfax :)

    "And we haven't even gotten to the internecine warfare of primary care doctors vs specialists!"
    ... not to mention the one between radiologists & cardiologists and the one between radiologists & gastroenterologists.
    It's all a conspiracy. They're out to get my fraternity ;)

  3. have 2 object! nurses have the right 2 complain. We r expected 2 take care of more & more pts while providing the same level of care. We not only have 2 do OUR job, but have 2 make sure the doc AND the pharmacist do theirs correctly. That is why there is such a bedside nursing shortage. Not nearly enough bedside care.

  4. Anon,

    I never said the nurses had a bad case -- certainly they have more legitimacy than Siemens or Big Pharma in demanding more resources. My point is that everybody is going to have their finger in the pot, and that's really going to complicate matters.


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