A Twitter Debate about Health Care reform

I had an interesting experience after  I used Twitter to note and lament the resignation of CMS Director Dr. Donald Berwick.  Craig Casey, an insurance agent in San Diego, sent several "tweets"disparaging Dr. Berwick and taking issue with"Obamacare". It is impossible for me to tweet an adequate reply to Craig, so I am using this column to reply point by point:
20+ million more on Medicaid equals Dr. shortage in / or rationing. you have elderly relatives Dave? 
This statement assumes that these folks were not receiving care before, and that suddenly they will now show up! The reality is, however, that they have been  seen for expensive and uncoordinated care in emergency rooms, and for complications due to no consistent primary care access. Obamacare will shift that to early primary care, and yes, we will need more folks to provide that care as things change.
Quoting his own comments about #Healthcare #rationing, he committed political suicide, no assassination. Good bye Obamacareite. Actually, Dr. Berwick has been a tireless advocate of safety in health care as head of the Institute for Health Care Improvement, and he has always focused on the patient and how we need to work together to achieve better outcomes of care. This work takes study and organization, which has caused him to step on a few toes in the insurance industry and elsewhere. This has lead to pressure by republicans in Congress to make his confirmation impossible. He should be proud of who his enemies are. Organized medicine has supported him completely.
The cost curve was bent upwards, health #insurance rates have jumped 20% since #Obamacare was passed UNaffordable care act. This is just not true. Insurance rates have been going up at an astronomical rate for years. The Employer Health Benefits Survey by the Kaiser Family Foundation, which specializes in health care issues, found that health insurance premiums have jumped by 9 percent in 2011. Drew Altman, president and CEO of Kaiser, said that the premium increase was not because of Obamacare but that the Obamacare law accounted for 1 to 2 percentage points. He noted, “It reflects the costs of covering young adults up to 26 years of age under their parents’ policies" and also "the costs of providing prevention benefits without cost-sharing". We can actually expect cost savings later from these measures!
Not when their reimbursement rates are being cut by the false promises of coverage via #Obamacare. This makes no sense to me. There is a problem at present due to the fact that Medicare rates are due to decrease 27%, because of the flawed update formula from years past, but that has nothing to do with Obamacare.
Since you And Berwick brought it up, MedPAC, IPAB, & CER. #Rationing equals #deathpanels. disprove it then. This is nutty talk. The reality is that we ration care now, and always have, by ability to pay. Even people with insurance are now often having trouble affording care. If we don't start paying for health care based on quality instead of volume, and work together to organize and provide services that we all need for a healthy and productive society, more of us will be priced out of needed care ever year. That is not an outcome that we can afford.

The Character Assasination of Dr. Don Berwick

Dr Don Berwick, one of the most highly qualified administrators ever nominated for public office, is about to be sacrificed on the altar of politics.  Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee, recently told reporters  that he has discussed Berwick's nomination with Republican senators and they plan to oppose Berwick under any circumstances. “Republicans won,” he said about the nomination.

Trouble is, I don't remember hearing about any fight.

Tom Curry, Executive Director and CEO of the Washington State Medical Association wrote in his March 14th Monday Memo to physician members that:

This is one of those instances where it would be better to fight and lose (while defending one’s view of the underlying reform legislation) than “duck and cover”.

I agree. This deserves to be a fight - a big fight - a loud fight. Dr Berwick is a world leader in understanding the problems of quality and inefficiency in US healthcare. It is an area of study and learning that he has dedicated his life to. His nomination is supported by all of organized medicine. Why? Because physicians know the quality of his work and the seriousness of our problems. The barrier to his confirmation is, interests that profit from our current mess are going all out to scare people and paint Don Berwick as a radical who wants to ration their health care. Consider the website donberwick.com. This site is a project of The Heartland Institute, who according to sourcewatch is "a frequent ally of, and funded by, the tobacco industry" who "now refuses to publicly disclose who its corporate and foundation funders are". They are also known to have been funded in the past by the tobacco, oil and gas industry as well as the infamous Koch Brothers.

Do we want shadowy, secretly funded pressure groups paid for by big business to make our decisions for us, before debate occurs, or do we want a full discussion in the light of day? This is disgusting. Our legislators need to hear from us now.