Well, President Obama clearly doesn't need your advice or "help" on becoming more effective in talking with ordinary working people who don't have a PHD or other degree like some people. And sometimes at public town hall meeting when answering a question President Obama can just go on and on and on and on and on ..... And when he does that he loses people.
Here's just one example from yesterday in Raleigh, North Carolina.
QUESTION: My name is Patty Briguglio. I own a company called MMI Public Relations. I have 20 employees, and I provide health care benefits for them. And so I wouldn't blow it, I've written down my question.
What current long-term social program created and run by the government should we look to as a model of success and one that we as taxpayers should feel confident that a new government-run health care system would be better than the current system in place?
In other words, what are you going to do differently?
OBAMA: Well, let me say this. Just in -- just in the health care arena, I'd point to two -- two areas. Medicare and the V.A. are both government-run health care programs that have very high satisfaction rates.
Generally, if you look at surveys, they have actually very high satisfaction rates.
Now, the V.A., because it's a self-contained system, meaning that people see patients, year after year, because they're not -- it's not dependent on what they job they have, they can actually do some things in terms of prevention and wellness and some of the things that I just talked about that have helped to lower their costs and improved quality of care, in a pretty impressive way.
Medicare is a different situation because seniors really like Medicare, generally. They appreciate the security that it provides. And by the way, we're in the 44th anniversary of the passage of Medicare.
Prior to that, senior citizens were extraordinarily vulnerable. And so it is a successful program. The problem with Medicare is -- is the same problem that we have with the health care system, generally, which is health care inflation has driven costs up. That's not unique to Medicare.
In fact, this is something that's important to know, that health care inflation under Medicare has actually gone down at a -- has actually increased at a lower rate than in the private sector. All right?
So -- so let me repeat what I just said, because everybody always says, well, government can't run anything. Medicare costs have gone up more slowly than health care costs in the private sector.
So the private insurance that you're getting -- you've actually seen your premiums go up faster than Medicare has cost taxpayers, even though seniors have high satisfaction rates with Medicare.
Now, having said all that, it's all relative. Medicare still needs to be a lot better and more efficient. And there are examples of how we can make the entire health care system more efficient.
We know where these examples are -- the Mayo Clinic, the Cleveland Clinic, Gessinger (ph), Kaiser Permanente. There are health systems around the country that actually have costs that are as much as 20 or 30 percent lower than the national average and have higher quality.
And so the question is: Why is that? What is it that they're doing differently than other systems? And there are some patterns that start coming into place. For example, number one is that they have a patient-focused practice, where instead of worrying about how they're -- how they're billing -- so how many tests they're ordering, or how many procedures they're ordering -- all they're focused on is the patient.
And they -- part of what helps is their doctors are all on salary so they don't even know what the economics of any decision that they're making are. Then it turns out you also have a group practice, so that when you come in, the family physician -- your primary care physician -- has already coordinated with all the specialists.
So instead of having to go to four different doctors and four different tests, you go and take one trip, and you see all of them all at once, and they all help diagnose you and coordinate your care throughout the process.
They've got health information technology so that when you take a test, it actually gets forwarded to the next doctor, and the next doctor, and the nurse and the pharmacist, so that there aren't any errors. So there are a whole range of, you know, practical things that they're doing that are improving quality and lowering costs at the same time.
Now, there's no reason that we can't duplicate that in both private and public settings across the board. But in order to do that, we're going to have to change how we reimburse, for example. So we've got to say to doctors and hospitals, "We're not going to reimburse you for the number of tests you provided. We're going to reimburse you, instead, for the quality of the outcome."
Here's another example: Right now, we just reimburse hospitals no matter how many times they re-admit you. Now, if you took your car to the shop and they fixed it, or you thought they fixed it and then two, three weeks later, you go back in and they're having to do the same thing, you -- you wouldn't feel good about paying twice for the exact same thing that you thought had been fixed.
But under Medicare, there is no penalty to hospitals for having very high re-admission rates compared to their peers.
So those are the kinds of things that can be changed.
Now, your broader question may just be, I don't have confidence in government.
But as I pointed out -- I just want to go back to my original point -- Medicare costs have gone up more slowly than private sector health care costs. That is documented.
http://www.washingtonpost.com/wp-dyn/content/article/2009/07/29/AR2009072901739.html-----------------------------
Now students .... were you all taking notes? There will be a test tomorrow!
And please keep David Axelrod off the Sunday talk shows! When he answers a question it seems he didn't hear the question and just turns on a pre-recorded talking points switch. Little feeling, compassion or spontaneity is on display when he mumbles along.