Obama's ignorance during his healthcare press conference and town halls more than cancels Palin's bad interviews

When I was watching Obama’s July 22 press conference in which he clumsily tried to sell his healthcare reform legislation, I was astonished at how much he revealed that he is — what’s a nice way of saying this? — intellectually uncurious, uninformed, misinformed and lazy. And that was before he announced he knew nothing about Sgt. Crowley arresting his friend but thought that Sgt. Crowley had acted stupidly. He has only added evidence for these characterizations of him during his town hall meetings.

Let me be the first to say that Obama’s public performances just from the July 22 press conference and his town hall meetings MORE than cancels out Sarah Palin’s bad interviews.

Two of the um, uninformed things Obama said about his healthcare reform bill were that we would choose better between the red pill and the blue pill, which I believe means choosing more frugally between generics and patented drugs. This was low-hanging fruit in cutting the costs of healthcare and is already being done. The second was claiming doctors would routinely perform tonsillectomies instead of treating a child with antibiotics because the surgery is more profitable. No. That’s not the way that works.

Is Obama so accustomed to having other people do his homework and taking credit for it that he has concluded from all the adulation that he does not have to do his homework on healthcare reform and the proposed legislation in Congress and no one anywhere will be informed enough to know the difference?

Wrong, Obama. Wrong.

Thanks to Hot Air I have come across a piece by Dan Calabrese that details Obama’s techniques as a “bullshitter” with great insight — it turns out the type of bullshitter Obama is matches the descriptions I’ve been giving of Obama as a sociopath (I boldfaced the most important points):

In a devastating commentary in the Wall Street Journal, Dr. Scott Gottlieb – a practicing internist, former official at the Centers for Medicare and Medicaid Services and currently a fellow at the American Enterprise Institute – demonstrated convincingly on Friday that President Obama simply doesn’t know very much about the practice of medicine.

If you want the details, read Gottlieb’s piece. But I reference it here because it fits a larger and very troubling pattern about the president: The more he talks, the more he reveals himself not to understand the very subjects about which he waxes on with such seeming eloquence.

There is a name for a person with a talent like this: He is an expert bullshitter. And I will be honest and tell you it’s a talent I share. Deploying this talent can be a lot of fun, and I don’t have a big problem with it if it’s used innocuously. Many a great con artist will stand there and talk with such confidence about this or that, you are absolutely convinced this guy knows exactly what he’s talking about. The truth is that he doesn’t have the slightest idea, but he’s very smooth in his use of the language and his tone of voice, so he convinces you he’s on solid ground when he really isn’t.

[snip]President Obama is one of the most talented bullshitters I have ever seen. He knows all the tricks. He reframes every issue so he can keep it focused on the stuff he wants to talk about, and avoids having to address things he knows nothing about. He tells you what you already think, and he does it so convincingly that you don’t remember you never mentioned thinking any such thing. And most impressively of all, he blatantly makes things up, and says them with such conviction, you can’t imagine they’re not true.

[snip]

This is what Obama does all the time. He waxes on about the economy, and about the decisive action that must be taken to address it. But if you actually consider carefully the statements he makes about the economy, you’ll start to figure out that he doesn’t really understand economics at all.

Obama went to the Middle East and made a series of speeches about strategic issues, about the Israeli-Palestinian conflict and about the wars in Iraq and Afghanistan. They sounded smooth, but for the careful listener, they betrayed a shocking lack of knowledge about the subjects he was addressing.

This should really surprise no one. We elected a president who has never worked in the private sector, who has never functioned as an executive at any level, and whose very brief work in the U.S. Senate consisted of no significant accomplishments. He has spent his entire life spouting left-wing inanities with great eloquence, but he has learned very little about how the real world works.

And yet he was elected president, in part, because people were convinced he was brilliant, and they were tired of the “dumb” George W. Bush, who had not only run a large state for six years, but had also run several businesses and earned a master’s degree from Harvard.

Turns out Barack Obama doesn’t really know very much about anything, a fact that is troubling enough by itself. But when you combine it with his apparent conviction that he should be put in charge of regulating all these things he knows nothing about, and then you add in his talent as a first-rate bullshitter – you end up with the most ignorant guy in the room making the decisions for the rest of us.

I call bullshit.

I still call sociopathy. “Bullshit” is just too benign a connotation to describe Obama’s rhetorical techniqes.

OK, so I checked out the piece that inspired Calabrese to write the piece above, and it has this hidden gem, which I have boldfaced:

Regulating medical decisions should not be the responsibility of a remote Washington bureaucracy. The only way to instill more reflection at the point of medical decision making is to give doctors and patients reasons to consider the cost of various options.

For doctors whom Medicare pays per intervention, the problem isn’t the fee-for-service model, but the way that the government program sets the fees. Fees are set according to a fixed price schedule with no tie to the physician’s quality, experience level, or the outcome of the service.

A more rational system would pay doctors for entire “episodes of care,” rather than individual procedures. Private health systems like the Geisinger Clinic and some Blue Cross plans have adopted this model and pay doctors for taking care of an entire illness.

Medicare doesn’t have the ability to track episodes of care. It has struggled to adopt even modest payment reforms such as restricted panels of providers, value-based insurance, and account-based coverage, where consumers control their own spending—all techniques used by private insurers to improve efficiency.

Medicare’s size demands that it keep payment systems simple. Thus it relies on fixed prices for checklists of services tied to discrete billing codes. These uniform payment rules reward low and high quality care the same. What’s troubling is that the heart of the president’s plan—a government-run “public” insurance program—is modeled directly on Medicare.

There are two reasons to pay attention to the proposal to pay doctors for “episodes of care.” One is, it rewards the behaviors that lead to the better outcomes. The other is, most people do NOT realize that NO ONE is helping them wind their way through the medical system any more — not since the 1990’s when costcutting measures were instituted to discourage doctors from referring patients to a network of specialists of their own creation. When that practice was halted, doctors were discouraged from looking at you and your illness as a whole and they were punished for guiding you through the healthcare system. Instead, diagnoses, tests and procedures were given billing codes — so medicine has been tilted toward practicing to meet billing codes. Insurance companies now are the ones that build networks of specialists. But still — before the 1990’s, your doctor would see you through, now no one does. Well, actually, very prosperous people can pay a medical concierge service to do this, or see a boutique doctor who has limited his or her practice to 800 or so patients who pay a monthly or yearly fee in addition to insurance for the doctor’s care. Or you have a spouse or parent or child or friend or caregiver like me. Those are the options.

I don’t think there’s anything wrong with concierge medicine or boutique doctors. But I especially want people over 40, who grew up with a doctor managing their care and guiding them through the system, to know that medicine isn’t practiced this way any more so that they know from the git-go of meeting with a doctor that they must be their own case manager and patient advocate. Changing the payment model to “episodes of care” is probably our best shot at putting the doctor back in his rightful place as a patient’s guide and protector in the healthcare system. But until that model is widely adopted, be aware: in our current system, you’re on your own and must take care of yourself despite the fact that you are sick and have the least ability to do the job well and wrongly believe that others are looking out for you.