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Obama: Government Will Decide Which Doctors Deserve “Rewards”

by Rush Limbaugh - May 19,2011

RUSH: We have a couple sound bites here from President Obama, who’s out there at the town hall at AARP headquarters. By the way, Andrea Mitchell, NBC News, Washington, when she introduced the show, she actually said Obama was appearing before a willing audience. A willing audience! (laughing) That’s an interesting way to describe a bunch of people that have been picked and chosen and screened: ‘a willing audience.’ As opposed to people who don’t want anything to do with this. So we have these two sound bites. See. New wrinkle he rolls out here. Listen to this.

OBAMA (sped up): We also want to start rewarding doctors for quality, not just the quantity of care that they provide. Instead of rewarding them for how many procedures they perform or how many tests they order, we’ll bundle payments so providers aren’t paid for every treatment they offer when they chronic — to a patient with a chronic condition like diabetes, but instead are paid for how are they managing that disease overall.

RUSH: Oh, no! This is getting worse by the day. Now Obama and his panel are going to judge the work of the doctors, not just the quantity? They are going to determine whether or not the doctor did the proper number of tests and handed out quality care? My gosh, folks. This is becoming more and more Orwellian every time this man opens his mouth about it. We want to start ‘rewarding’ doctors? Doctors work! They get paid. What is this reward business? Who are you to reward them anyway? Who the hell are you? Your career has been five minutes. You spend 150 days working in the Senate. You organized riots and communities and stuff in Chicago. And he’s now going to run the medical business and appoint people to determine how well doctors are doing their jobs? Listen to that again. Play that sound bite again. Play that sound bite again. Play that sound bite again.

OBAMA (sped up): We also want to start rewarding doctors for quality, not just the quantity of care that they provide. Instead of rewarding them for how many procedures they perform or how many tests they order —

RUSH: Ah, man.

OBAMA (sped up): — we’ll bundle payments so providers aren’t paid for every treatment they offer when they chronic — to a patient with a chronic condition like diabetes, but instead are paid for how are they managing that disease overall.

RUSH: How would you know? How in the world would you know? Bundle payments, so providers aren’t paid for every treatment they offer a patient with a chronic condition like diabetes? (interruption) What’s the question? Official program observer has a question. What’s the question? (interruption) Mmm-hmm. Mmm-hmm. Mmm-hmm. Well, that’s a good question. The program observer has just asked me, some patients are lousy patients. Some patients refuse to cooperate. Some people with diabetes go in and get the insulin shot and think they can have a piece of cake and a bowl of potato chips or what have you. And then, you know, not long after they’re on dialysis. Well, I can answer this question for you. You are going to be denied coverage if you aren’t trying to help do the right thing for yourself. You are not going to be treated. You are going to be deemed too expensive. The investment in you is not going to be worth it. Where else can this possibly go? Just listen to this one sound bite? If I’m a doctor in this country and I hear that — if I’m one of the 40 willing people at this put up, phony seminar today and I hear this man who nobody knows, say this? We know more about his friendship with ‘Skip’ Gates than we know about his five-minute career. He’s going to sit there in judgment of the quality of the work doctors do? I can’t wait to listen to this next sound bite. I can’t wait to listen to this next sound bite.

OBAMA (sped up): Here’s a guarantee that I’d make. If you have insurance that you like, then you will be able to keep that insurance.

RUSH: Nope.

OBAMA (sped up): If you have a doctor that you like, you will be able to keep your doctor.

RUSH: Nope

OBAMA (sped up): Let me also address I think a misperception that’s been out there, uh, that somehow there is any discussion on Capitol Hill about reducing Medicare benefits. Nobody is talking about reducing Medicare benefits.

RUSH: Yes, they are!

OBAMA (sped up): Medicare benefits are there because people contributed into a system.

RUSH: It’s bankrupt!

OBAMA (sped up): It works. We don’t want to change it. What we do want is to eliminate some of the waste that is being paid for out of the Medicare trust fund that could be used more effectively to cover more people and to strengthen the system.

RUSH: Ugh. Next he’s going to do a seminar on how the build a bubble car, and he’s going to sit in judgment of the people that do that. There are cuts in Medicare! Heritage has found them. Let’s tell you something else, folks. At his press conference last Wednesday night, he insulted doctors by accusing them of doing unnecessary organ removals to line their pockets. He’s insulting them again here. They don’t do quality work. He’s going to reward them if they do quality work. And let me tell you the clincher here. How in the world can they possibly know whether you’ve got quality care without getting into your medical records? That’s the only way they can know. They’re going to digitize them, make it electronic. How else? They can’t have an Obamacare bureaucrat in every doctor’s office watching the procedure, grading it on a clipboard and sending the results back to the Oval Office.

They can’t do it that way. No. He’s insisting it’s not government controlled. It’s not going to cost any more money, you’re not going to lose your doctor. Your doctor might get canned if Obama doesn’t think you’re doctor is doing quality work. And if you are an uncooperative patient — you know, if the doctor diagnoses you got high cholesterol and prescribes whatever the drug for that is and if you don’t take it — well, how are they going to know whether you’re taking the medicine or not? They know it, it will be prescribed, but how do they know whether you’re taking it? What if you go in and the doctor says, ‘Have you been taking the medicine?’ You say, ‘Yes’ when you haven’t. Well, then you’ve just created a problem for the doctor. This is so insulting. He insulted insurance companies, too, Wednesday night. Their profits are immoral. We’re going to squeeze those profits.

But you’re going to be able to keep your doctor, gonna keep your insurance plan, gonna keep everything. The hubris, the absolute hubris. Where are just loads and loads of people asking, ‘Who the hell are you to judge the quality of medical care? Who the hell are you? Show me in the Constitution where this fits the job description.’ Play sound bite 28 again. This is mind-blowing.

OBAMA (sped up): We also want to start rewarding doctors for quality, not just the quantity of care that they provide. Instead of rewarding them for how many procedures they perform or how many tests they order, we’ll bundle payments so providers aren’t paid for every treatment they offer when they chronic — to a patient with a chronic condition like diabetes, but instead are paid for how are they managing that disease overall.

RUSH: As though a disease is ‘manageable’ in every patient. Look, I understand this guy better than anybody, and I am still stunned by this. There ought not be one doctor in this country supporting this. There ought not be one nurse because they’re going to be culpable, too. You know, they’re in the game. And let’s get into dentistry now and start judging the quality of that, and how much dentistry is cosmetic and is going to be taxed at 10%? Now, remember at the infomercial that ABC did for Obama back in June — or maybe it was earlier this month, I forget. But last 30 days or so. It was the infomercial on Wednesday night from the East Room with Obama taking questions.

Remember the woman that got up and asked him about her 100-year-old mother who was taken in and the doctor said, ‘You need a pacemaker. I can’t do anything else for you, and I’m not going to put a pacemaker in you. You’re a hundred years old.’ So the woman and her mother went to another specialist who said, ‘You know, you’ve got a lot of spunk. I’ll be glad to do it,’ and five years later she’s perfectly fine with the pacemaker, he’s 105 years old. This woman whose mother got the pacemaker at age 100 asked the president of the United States… Now, stop and think of this. I can understand this question being asked of Fidel Castro. I can understand this question being asked of Hugo Chavez. I can understand some serf citizen pleading with his leader to let his mother live. But I can’t imagine that in this country, and it happened.

This woman stood up: Are you going to take into account, Mr. President, Dr. Obama, are you going to take into account a person’s ‘spirit’ and their desire to live? Do you know what Obama said? ‘Look, the first thing for all of us to understand is we actually have some choices to make about how we want to deal with our own end-of-life care, and we can’t get into spirit and spunk. We as a culture and as a society can start to make better decisions within our families and for ourselves. At least we can let doctors know and your mom know, ‘You know what? Maybe this isn’t going to help. Maybe you’re better off not having this surgery but taking the painkiller.” That question was asked, and that answer was given in the United States of America. That question was asked in the White House.

Those are the kinds of fearful questions people who live in banana republics ask, and the answer is always no unless the family is somewhat prominent. Now, I also want to share this quote with you because the Republicans send out mail, newsletters to constituents. Representative Ken Calvert, who is a Republican from California, attempted to mail a newsletter to his district covering the issue of health care, and the Democrats made him remove that quote of the president I just read to you from the newsletter. He was forced to remove that language — it was called ‘offensive’ by the Democrats. ‘He was forced to remove that offensive language before Democrats on the Franking Commission would approve payment of postage for the mailing.’ Connie Hair has this as Human Events.

Now, here’s this great wordsmith. Here’s this Great Communicator who’s really got a communication problem these days. Here’s this smart, elegant, young, articulate president, and he’s saying so many things that are embarrassing that the Democrats are not letting Republicans put his own words in mailings that they’re sending out. This is the United States of America. You doctors out there, you know what you’re facing if you stay in this business and this thing happens? You are going to be become indentured federal servants, and you’re going to have reports — who knows how often, on your work — patient by patient. And somebody in Washington is gonna say whether or not you’re doing quality work. And if it’s judged that you’re doing quality work — and I’ll guarantee you this: The odds are that if you are a Republican doctor and you have not donated to Democrats, and there’s no record of you making campaign contributions to Democrats or Obama, your work will not be judged as often as ‘quality’ as Democrat doctor donors’ work will be judged as quality. You’re going to be filling out these reports or somebody is and they’re going to be getting into patient medical records to find out what you’ve been doing in order to judge your work. And then they’re going to ‘squeeze’ your costs and payments. They’re going to ‘bundle’ payments, whatever the hell that means. Sounds like we’re in the bundle-payment business. How would you like to have a job where you get paid in bundles, whatever the hell that is. And all of it from Washington or some mythical insurance company.

BREAK TRANSCRIPT

RUSH: I’ve been told what bundling payments is. You know what it is? Well, tell me. I want to make sure that the caller is right because we know I am. Hm-hm. Hm-hm. Hm-hm. Hm-hm. Hm-hm. Hm-hm. Right. Yeah, they basically withhold payments and they send a bunch of payments at once in a bundle, so there’s no cash flow for the doctors here. It’s just whenever the government gets around to doing it. And of course if they don’t do it, where else are you gonna go? There’s nowhere else, they were going to have a monopoly on this. You know, I cannot tell you, folks, how offensive this is and how dangerous. We are at a dangerous time in this nation’s life. We have a president who doesn’t know up from down. We have a president who knows nothing about anything in the private sector. All he knows is that he doesn’t like it. He thinks it’s unjust, it’s immoral and it’s unfair. The wrong people get rich. The wrong people get poor. And he’s bound and determined to fix it.

So now he’s setting himself up, after putting doctors down again, as the judge of the quality of their work, or some agency that he’s going to appoint. I’m sure that his agency will be full of other doctors. You know what, Mr. President? I got an idea for you. As I look at it, the thing you do run is an absolute embarrassing mess. The United States government is a mess. We are bloated with debt. You have taken money from grandchildren not yet born in order finance this destruction of this capitalist system, private economy that you don’t like because you don’t think it’s fair. The federal government is an absolute disaster. You do run that. How about increasing the quality of services of the federal government? Notice that he never does anything about what he is actually in charge of? He is reaching out to be in charge of everything else but what he’s in charge of. He takes no responsibility for anything that he is already running. He always takes and talks prospectively because that way he can avoid accountability.

BREAK TRANSCRIPT

RUSH: We gotta ask ourselves a question. Why all these attacks on doctors? The cosmetic surgery tax is an attack on doctors. Saying that pediatricians schedule unnecessary surgeries for kids so they can line their pockets is an attack, and now this man is going to judge their work? And he doesn’t apologize for what he’s doing to impugn an entire profession. In whose polluted mind are doctors the enemy? But they damn sure appear to be with this man. Just like the Big Oil executives are the enemy and just like the insurance agents are the enemy. Wall Street executives are the enemy. Car executives are the enemy. Is Obama going to protect the doctors from the folks with pitchforks? What is the reason for the attack, the demonization of all of these different endeavors? He’s demonizing them to clear the field, folks, like the car execs and like Wall Street. Doctors are being undermined and attacked in order get this stupid bill passed. He wants as many people to think that the problem in health care is two things: their greedy doctors and super greedy insurance agents. I’m seething, that first sound bite we played, he’s going to judge the quality of their work and bundle their payments. All right, we’ve got four more and a doozy when he talks about death, but, here, let’s just get to them in order.

OBAMA (sped up): You get these stories where all — there’s a trillion dollars here, trillion dollars there. After a while, it starts being real money, even here in Washington. So I understand people being scared that this is going to be way too costly. It’s not that costly if we start making changes right now. We spend about $6,000 per person more than any other industrialized nation on earth, 6,000 more than the people who live in Denmark or France or Germany or — every one of these other countries spend at least 50% less than we do and, you know what, they’re just as healthy.

RUSH: I’m just… (pause) very few things can render me speechless. Okay, well, Mr. President, the next time one of your two little girls gets sick, fly ’em over to Denmark. Don’t burden the US health care system, which is the best in the world, and the best costs. Let’s just keep firing away. I don’t know how much longer I can objectively analyze this drivel. But here’s another one.

OBAMA (sped up): I do think this is a concern that people have generally. My interest is not in getting between you and your doctor.

RUSH: Stop that tape. Go back and grab number 28. I do think this is a concern. ‘I have no interest getting between you and your doctor.’ Play cut 28 again.

OBAMA (sped up): We also want to start rewarding doctors for quality, not just the quantity of care that they provide. Instead of rewarding them for how many procedures that they perform or how many tests they order, we’ll bundle payments so providers aren’t paid for every treatment they offer when they —

RUSH: That’s enough. That’s enough. Okay, so reward the doctors for quality health care and then here, number 31 again.

OBAMA (sped up): I do think this is a concern that people have generally. My interest is not in getting between you and your doctor.

RUSH: But —

OBAMA (sped up): Although keep in mind right now insurance companies are often getting between you and your doctor.

RUSH: Here we go.

OBAMA (sped up): What we just said is we just want to provide some guidelines to Medicare and — and, by extension, the private sector, about what works and what doesn’t. Some of you may have heard we wanted to set up what we’re calling an IMAC, an Independent Medical Advisory Committee, that would, on an annual basis, provide recommendations about what treatments work best and what gives you the best value for your health care dollar.

RUSH: For crying out loud, you’re going to need to go to a library before you go to the doctor. There’s always a ‘but,’ there’s always an ‘although.’ My interest is not getting between you and your doctor, although keep in mind right now insurance companies are often getting between you and — yeah, yeah. Hate those insurance companies. We’re going to get even with them. We’ll get even with the doctors. Here’s the next one.

OBAMA (sped up): The reason this has been controversial is a lot of people have heard this phrase ‘socialized medicine.’ And they say we don’t want government-run health care, we don’t want a Canadian style plan. Nobody’s talking about that. We’re saying let’s give you a choice —

RUSH: Wait a second! Stop the tape! We just got through listening to three sound bites where some of the most intricate, delicate, complicated, complex, control of the health care system was just explained, and now he says that that’s not going to happen. Here, play 32 again. I promise not to interrupt.

OBAMA (sped up): The reason this has been controversial is a lot of people have heard this phrase ‘socialized medicine.’ And they say we don’t want government-run health care. We don’t want a Canadian-style plan. Nobody’s talking about that. We’re saying let’s give you a choice, you can choose the private marketplace or this other approach, and I got a letter the other day from a woman who said, ‘I don’t want government-run health care; I don’t want socialized medicine, and don’t touch my Medicare.’ (laughter) And — and — you know, you know, I wanted to say, well, you know, I mean, that’s what Medicare is, is it’s a government-run health care plan that people are very happy with.

RUSH: Medicare is a government-run plan that people are very happy with? We don’t want to run your government, though, we don’t want to run your health care, keep your option. Folks, this man is prevaricating. None of this is true. This is just breathtaking, that this took place inside of a half hour. Now, this next one, he gets a question, this a tele-town hall is what they called it and he got a call. The caller said, ‘I’ve heard lots of rumors going around about this new plan. I hope the people that are going to vote are going to read every single page. I’ve been told that everyone that is of Medicare age will be visited and told to decide how they wish to die. This bothers me greatly. I would like for you to promise me that this is not in the bill.’

OBAMA (sped up): I guarantee you first of all we just don’t have enough government workers to send to talk to everybody to — to find out how they — they want to die. I think that the only thing that may have been proposed in some of the bills — and I actually think this is a good thing — is that it makes it easier for people to fill out a living will. Everything is going to be up to you. And if you don’t want to fill out a living will you don’t have to. I just want to be clear, nobody is going to be knocking on your door, nobody is going to be telling you you’ve got to fill one out, and certainly nobody’s going to be forcing you to make a set of decisions on end-of-life care based on, you know, some bureaucratic law in Washington.

RUSH: That’s exactly right, the bureaucrat’s going to make the decision, you aren’t. You’re not going to have to any say in the matter, and it’s in the House bill. Once you reach, I don’t know what the age is, it’s in the 60s, every five years some counselor shows up to start counseling you, ‘Okay, we both know that you got a lot more years behind you than you have in front of you and we gotta talk about what the next few years hold and look at your health as it is now and, oh, by the way, here’s this living will we want you to fill out.’ When he says they don’t have enough government workers to go around and counsel people, the answer to that is, ‘We don’t have enough yet, but we can get ’em. We can get ’em from the union; we can get ’em from the service employees union; we can get ’em from the teamsters.’ How would you like some of those guys coming in to counsel you at your end of life? Well, I know, it does sound funny. I’m telling you, this is frightening, and it’s real. Medicare can only work, folks, because of private doctors, private drug companies, private innovations in health care. That’s the only way. There’s nobody in government right now making our health care system work. They have nothing to do with it. But all of a sudden, for some reason, enough people — it’s not a majority, but clearly a lot of people think this man is qualified to design this and manage it.

BREAK TRANSCRIPT

RUSH: I want to play an Obama sound bite, play it again here because I think in this sound bite he’s got a question: ‘Am I going to be able to see a cardiologist if I have a heart condition or other specialist or is that all going to be primary care? I’m calling it ‘rationing of care.” That’s the question, and here’s his answer, and I think in this answer we don’t even need doctors. We’re not going to need them. This is his answer.

OBAMA (sped up): I do think this is a concern that people have generally. My interest is not in getting between you and your doctor, although keep in mind right now insurance companies are often getting between you and your doctor. What we’ve said is, we just want to provide some guidelines —

RUSH: Mmm-hmm.

OBAMA (sped up): — to Medicare as and by extension the private sector about what works and what doesn’t.

RUSH: Okay, stop the tape. We don’t need doctors. Just put out the list of what works best. Just put a list out! Medicare can handle this, right? Just put out a list of what works best and have somebody do that. Can you imagine the president of the United States has to say, ‘I don’t want to get between you and your doctor’? That’s something Mikhail Gorbachev would say, except they didn’t have many doctors over there.

Fred in Cleveland, hello, sir. Welcome to the one-and-only EIB Network.

CALLER: Rush, it’s a true honor. Mega dittos from a conservative entrepreneur in Cleveland.

RUSH: Thank you very much, sir.

CALLER: You got it. My point is, I think that our president and his liberal agenda and his Chicago thug politics are coming to a head, and I think that the American people are finally waking up and I think the door has been open over 30 or 40 years of them manipulating education. I think Obama’s trying to kick the door wide open, and I think it’s too early and too soon. I don’t think they have the power to do it, and I think people are coming alive and realizing what his true agenda is, and we’re going to put a stop to it. I think if we can win some seats in 2010 —

RUSH: Let me tell you something. Let me tell you something. I do believe this. I do believe more and more people are saying, ‘This is not who we thought we were voting for. We thought we were voting some magical postracial, postpartum (I said it on purpose) postpartisan, politician.’ They’re not… This is not who people voted for, but he doesn’t care. He can see the polls now, Fred. He can see that nobody wants his plan and that nobody wants his cap-and-trade plan. It’s not going to stop him. Whether or not… You know, I think there have been so many instances in history where people should have seen the follies of liberalism that they would never, ever get elected in large numbers ever again. But, they do, because they are filled with deceit.

Obama would not have gotten elected had this agenda been perfectly laid out as he’s executing it. It wouldn’t have stood a chance. That’s why people are starting to say, ‘This is not the guy I voted for.’ Then you got some people just scared to death like these poor people, these 40 or whatever was willing participants in the tele-town hall today. They’re just scared that they’re going to lose their medical coverage and treatment, and anything that they can hear that reassures them that’s not going to happen — it may in fact get better and a couple billionaires going to actually pay for it! — at some point in your life, that’s really all you care about. So anyway, it’s been a great day for eye opening. It’s still shocking. We are at a perilous path. These are dangerous times in our country. I hope Fred from Cleveland is right about the number of people waking up. But as my good friend Michael Ledeen says: Faster, please.