Effect Measure

Franken-sense: it’s about time

Al Franken may have made his name as a comedian on Saturday Night Live, but as a Senator (D-MN) he’s a force to reckon with. In this clip from hearings this week he nails a witness from the right wing Hudson Institute pimping for the health care industry. Her claim? That health care reform would lead to more bankruptcies. He makes his point and thanks the witness, but she tries to score with a question of her own. Bad move. It turns out Franken knows the answer:

Smart, serious, prepared. Live from Washington, DC. It’s not Saturday Night Live!

Addendum, 1 pm EST: Just had to take my son-in-law to the Emergency Department (not flu related). There’s a two hour wait to be triaged. It’s not people with flu that’s the problem. That wait is “normal” (it’s been as high as five hours to be triaged). It’s a broken system.


  1. #1 The Ridger
    October 25, 2009

    Considering that “go to the emergency room” is the “health care” the Republicans tout as why no American is without it, that should come as no surprise.

  2. #2 Meat Robot
    October 25, 2009


    Even in socialist Canada you’ll get triaged in minutes.

  3. #3 Grace RN
    October 25, 2009

    Hope your SIL is OK-he’s lucky to have you. At least someone in the waiting room could administer first aid if needed.

    That’s sure not triage, it’s more like this:


    The everlasting gobstopper long-a-waiting room?

  4. #4 maxh
    October 25, 2009

    Ye Gads, 2 hours is a long wait. Though to be fair, after I’ve been triaged I’ve had to wait 2 hours to be seen on the NHS (though for a fairly minor cut that just needed a couple of stitches). That sad, I do think that the NHS provides very good emergency care. It does have its flaws, don’t get me wrong (I had to wait 3 years to get braces, for instance) BUT if I fell off my horse and broke my leg, I’d be in hospital and operated upon within the hour (in fact, a friend had her horse fall on her during a cross country course and was airlifted to the nearest hospital within 30 minutes).

    And it is misleading to call this free healthcare, but if paying a tiny amount of my wage every month means I don’t have to worry about paperwork/payments/etc while in agony, then it’s free enough for me!

  5. #5 Mike
    October 25, 2009

    Waiting 2 hours is quite normal in a NHS system as in the Scandinavian countries as well if not anything deadly (often more). I took my son to the emergency room for a possible concussion and had to wait for 5 hours in a way too warm ER. Not nice.

  6. #6 C. Corax
    October 25, 2009

    My mother was taken to the emergency room by ambulance a few back, so she got right in. I went with my brother and sister-in-law to visit her. Since only two could visit at a time, I waited out with the folks waiting for triage, and had plenty of time to study the miserable group which overflowed the waiting room. First of all, the entire hour and a half to two hours I was there, the triage station was empty. In other words, there was no one doing triage for people coming in. At all. They simply had to wait and wait and wait. People kept collaring nurses as they went in and out of the emergency room and they all got the same answer–“It’s up to triage if and when you get in.” One man was with a young woman (daughter?) and told the nurse that they’d been waiting for six hours with the young woman in pain. The nurse pretty much shrugged and said there was nothing she could do.

    Outdoors, there was the regular wailing of sirens as ambulances came in from several counties every twenty minutes or so. When I finally went in to see my mother, I had to weave between beds that lined both sides of the hallways, were pushed up against the central work island, and waited beside the already-in-use bays. The chance of anyone in that waiting room setting foot in the ER before the next morning looked about nil to me.

  7. #7 Paula
    October 25, 2009

    About ten years ago, I waited in one Kaiser ER, in California, 1 1/2 hours for triage, 4 hours total wait. Like maxh here, I simply needed a bad cut stitched, but there were also people waiting nearly as long for triage with serious conditions. I’m not convinced that compromise reform solutions–those to be paid for through use of the medical home model and bundled (Medicare) payments–will solve this problem, given that this is already the Kaiser model. (Admittedly, Kaiser’s ER was swamped not only by Kaiser “members.”)

  8. #8 BostonERDoc
    October 25, 2009

    As an ER physician, I am very qualified to comment. Two hours to be triaged is not acceptable. National standards are 15 minutes to be triaged. The wait to be seen by a physician after triage is another matter-typically up to 6 hours depending upon your chief complaint and your vital signs. It is simple math at work: too many people not enough resources, docs etc. Keep in mind we have over 120 million ER visits in the US alone and we have shut down over 200 hospitals in the past 10 years.

    The suits in Wash are also ignorant of this crisis. All I ever here out of them and the president is that ER care is too expensive (it isnt), or people are misusing the ER (they are not). It is a myth to believe most ER visits are for something that shouldn’t be seen in the ER or that the uninsured are using the ER for primary care–both account for only 20 % of visits–the remaining 80% are legitimately in need of the ER services.

    Ensuring proper resources and decreasing the burden of paperwork needs to be fixed before any meaningful health care reform will work. If you add an extra 20 plus million to the list and not add new ERs you are in for a lot of hurt. I hope your son in law is alright Revere. I suggest you befriend a local ER doc to expedite any future ER visits.

  9. #9 daedalus2u
    October 25, 2009

    What I found interesting is how straight-faced the witness was, even as she knew she was dissembling; even as Franken caught her dead-to-rights dissembling. I couldn’t detect a hint of shame or embarrassment. Not at what she was saying, not at what she was caught dissembling about.

  10. #10 Karen
    October 25, 2009

    Two hours for triage? Damn.

    I have no problem with a bit of a wait once triaged, or even with being bumped by someone with a clearly more serious problem in the triage line, e.g. my broken shoulder was clearly less serious than the guy who lost a fight with his lawnmower. If I need an ER, but know I’m at the bottom end of needing their services, I grab a book and thank my lucky stars I’m not at the top of the list after triage if the ER is busy.

  11. #11 D. C. Sessions
    October 25, 2009

    From upstream of BostonERDoc, our ski patrol has taken to specifically directing people to the area walk-in clinics (“Doc in a Box”) for anything they’re qualified to do. Dramatically shorter wait times for most complaints, and (speaking with some knowledge) better care for enormously less money.

    The key part is, “anything they’re qualified to do.” Find out in advance. We don’t send neuro to them, for instance. Lacerations? Sure. Fractured extremities, sprains, strains, etc? You bet. Fractured elbows? Not on your life.

    When a dislocated shoulder can wait for hours to be reduced, I send people where they’re going to get taken care of.

    Call in advance.

  12. #12 Doug
    October 25, 2009

    Brave man! I admire a Senator who’s willing to speak truth to power.

  13. #13 Susannah
    October 25, 2009

    No wonder they fought so hard to keep him out of office.

  14. #14 Phila
    October 26, 2009

    There’s a two hour wait to be triaged.

    When we were living in NYC, my wife had a kidney infection and went to the ER. It took well over an hour for triage. At which point, they decided her situation was no big deal.

    From that point, it was 11 hours before she saw a doctor and got treatment. The doctor told her she should’ve been seen before almost all of the patients who’d been taken ahead of her.

    A broken system means more stress, more confusion, and more potentially deadly mistakes.

  15. #15 Thomas
    October 26, 2009

    This is really bad, really anti-intellectual stuff here from Franken.

    Franken is just wrong on the bankruptcy issue, at least if he’s trying to offer comparisons to the US. The way we get these absurdly over-inflated numbers on bankruptcies in the US is from surveys that ask, among other questions, whether there were two weeks or more of lost income due to injury or illness. Is Franken saying that because of the differences in the health care systems in those countries that no one–not one solitary individual–has lost time on the job due to sickness and then subsequently declared bankruptcy? That’s just absurd on its face. And yet that’s what he confidently asserts, and what’s cheered on here.

    And he’s really not much better on the cancer studies. Saving your skepticism for the studies that say things you don’t like isn’t a good way to go through life. Partisanship makes you stupid, I guess.

  16. #16 Kristjan Wager
    October 26, 2009

    Thomas, given the fact that every article I’ve read on the subject, supports Franken’s claims regarding bankruptcies in the US, I’m more likely to trust him than you.

    E.g. see Study Links Medical Costs and Personal Bankruptcy, where the researchers looked at the reasons cited when filing for bankruptcy. Here “serious medical problem” went up from 8% in 1981 to 62% now.

  17. #17 revere
    October 26, 2009

    Thomas: Partisanship makes you stupid, I guess.

    LOL. Well, that’s a two way street. See Kristjan’s note (#16). And the cancer issue? Do you know what he’s talking about? If you include cancers picked up by screening as practiced in the US it artificially inflates survival. But I guess you know that if you are an epidemiologist. You are an epidemiologist, aren’t you? Or maybe just another stupid partisan.

  18. #18 FreakyBeaky
    October 26, 2009

    It really is refresing to see a lobbyist treated with that level of utter contempt. Go Al!

  19. #19 Thomas
    October 26, 2009

    Kris, thanks, but I’ve read the study while you’ve read the Businessweek article about the study.

    revere, yes I do know what he’s talking about. And he’s drawing some pretty solid conclusions when tentative conclusions would be more appropriate. I mean, the good senator from MN isn’t an epidemiologist either, and yet when he purports to debunk the work of epidemiologists, you don’t complain do you?

    And I’d note that you don’t have a response on the bankruptcy issue, where it’s clear that Franken is just making things up.

  20. #20 Cate
    October 26, 2009

    No Thomas, Franken and the reports on bankruptcy are not just making things up — you are. You (think you are) are skilled in setting up ‘straw men’ — so you are just here to bother people.

    Medical bankruptcies have nothing to do with being off work for two weeks, as you try to suggest. Medical bankruptcies are about having your insurance deny payment for the medical care needed to save your life, or your child’s or spouse’s life. France, Switzerland, Germany do not have medical bankruptcies. We have thousands upon thousands each year. Our citizens are suffering because our health insurance does not pay for their medical care. Facts are facts.

    Methinks we have a troll . . . and its name is Thomas.

  21. #21 Thomas
    October 26, 2009

    I’m sorry Cate, but medical bankruptcies as you imagine them and medical bankruptcies as they are defined in the various academic studies aren’t the same thing. As the studies use the term, you have a medical bankruptcy if the bankrupt individual missed more than two weeks of work due to illness or injury. If you think that those shouldn’t be included in the category of “medical bankruptcy”, take it up with Elizabeth Warren. If you think that those events don’t occur elsewhere, you are nuts.

    Do you realize that studies of medical bankruptcies in the US show that a significant number of the medical bankruptcies occur for people who are on Medicare and Medicaid?

    Methinks that most of you haven’t a clue about this issue and don’t like it when someone points that out.;

  22. #22 Cate
    October 26, 2009

    Oh my goodness you found a criterion that you could pounce on to try to make your false point. The criterion that is sending you into your “Oh boy, I’ve so got you NOW!” game move is an indicator to identify cases. If better data were available, we would not have to use indicator data — but we are epis, and know that. Maybe the true rate is 10 – 15% less — that is still thousands upon thousands of American citizens who are thrown into poverty to protect health insurance company profits.

    The point that you keep trying to steer us away from: medical bankruptcies do not occur in Switzerland, Germany, etc. That number is zero. So, even if we halved our estimates we’d still have thousands upon thousands of American citizens thrown into poverty so your cronies could keep raking in profits. But apparently you don’t care about the people who are sick and unable to get their insurance company to pay for their treatments and then lose their financial safety, do you?

    Are you a health insurance exec profiteer, a lobbyist profiteer, a stockholder profiter, or a lowly paid scibbler for them?? Come on . . . we are epis and other medical professionals. Now which of the health care insurance vampires are you, Thomas?

  23. #23 Thomas
    October 26, 2009

    Oh my goodness, I’m using the definition of “medical bankruptcy” that Al Franken uses! How outrageous! And, yes, using Al Franken’s definition, medical bankruptcies occur all the time in Switzerland, Germany, etc.

    You also apparently don’t understand bankruptcy, which doesn’t throw anyone into poverty. (You do have the typical professional class fear of bankruptcy.) In the US, bankruptcy doesn’t throw anyone into poverty, it eliminates the obligation to pay one’s debts. Which means that debts owed to rich doctors and health care providers are eliminated. Why are you trying to protect rich doctors?

    If you don’t know anything about policy issues and can’t be bothered to learn about them, why do you opine on them? Stick to what you know.

  24. #24 Paula
    October 26, 2009

    Thomas, having worked in the past for a bankruptcy law firm, I would point out that even chapter 11 bankruptcy, which allows firms to continue their struggling operations, puts them under enormous restrictions, nor are they freed from (if slowly and/or partially) repaying debts. As for chapter 7 bankruptcies, an acquaintance was, last year, thrown into medical bankruptcy and has lost nearly all her assets and her home. I really don’t know why you are making false points here.

  25. #25 Phoenix Woman
    October 26, 2009

    Paula, Cate, et al: I suspect Thomas is a Hudson Institute employee road-testing various teabagger arguments in frillier dress to see if he can slide them past more literate folk than the ones who attended the teabagger rallies this summer.

  26. #26 Cate
    October 26, 2009

    Phoenix Woman, Paula, et al:
    Yes, Thomas/a ‘deftly’ ignores questions about who s/he is.

    Unfortunately, my parents led the republican party for half of our state — the GOPers all LOVED doing dirty tricks. They were always planning what they would do to get at this person, to do in that democrat. One of their big things was to try to get democrats fired from their jobs. Fortunately, I realized that all of them were paranoid by the time I met Mr. Nixon. Whoa Nellie, was he unpleasant. He knew small children had him all figured out!

    Never once in all of my work with democrats have I ever heard of democrats doing, or even thinking of doing, dirty tricks. Such an amazing difference in thinking between the two groups. The GOPers see conspiracy and dishonesty in everyone but themselves. They torment themselves and the world, and then blame us for their terror.

    But to try to keep people suffering from horrific profiteering ‘health insurance’ companies — that is immoral.

  27. #27 Thomas
    October 27, 2009

    Paula, an individual can choose to file bankruptcy under Chapter 7 or Chapter 13, but not under Chapter 11. Without knowing the facts I can’t be certain, but I’d be surprised if the assets involved in the bankruptcy case you mention were significant.

    Cate,Phoenix, I’m the sort of person who is annoyed by smart people acting stupid, which is what I saw–and see–here. If you know someone who wants to pay me for expressing my annoyance, I’d be happy to listen. To have the benefit of a mind and to refuse to use it–that’s immoral.

  28. #28 Paula
    October 27, 2009

    Cate and Phoenix, I think best is to ignore Thomas’s posts; in response to mine, he is, as with others’, throwing out strawman flak; regarding yours, he seems to be simply name-calling.

  29. #29 M. Randolph Kruger
    October 27, 2009

    Health care at all costs Revere…?

    If this goes in, the unemployment rate is going to skyrocket. You are a smart guy, but you only have to budget in what you do. The system where you are living is the mandated, forced healthcare system. Sorry about your son but Dad, you just cant see the forest because of all of the trees.

    This leftist spendathon is already doing us and the end result may be the dissolution of the United States of America. Its cheaper to secede.

    High taxes, followed by higher taxes and then the inevitable rationing of healthcare because they cant throw the baby out with the bath water once there are real numbers put on what you want to do. Every system has inevitably gone broke and it has always lead to bigger and bigger numbers.

    If you think Franken is scoring points…maybe. But in the reality of things people are going to revolt if this goes in.

  30. #30 M. Randolph Kruger
    October 27, 2009

    Oh and Cate, BTW even when they are caught down here with election fraud they still deny.

    As in being in Chicago when they are signed in as election wardens in their precincts and voting the dead people who live in vacant lots on election day arent dirty tricks.

    Even the process that put Franken in didnt take the voters in. Franken is a one and done.

    But stick around… I know I am on the enemies list.

    I though fight back.

  31. #31 Shay
    October 28, 2009

    Without knowing the facts I can’t be certain, but I’d be surprised if the assets involved in the bankruptcy case you mention were significant.

    For a working family, I think a car and a house qualify as significant assets, don’t you?

  32. #32 Paula
    October 28, 2009

    Shay, thanks. I just didn’t want to keep replying to him. And yes, you are right; as with “significant risk,” loss of “significant assets” is simply what for the person/s involved can be disastrous.

  33. #33 Grace Colasurdo
    October 28, 2009

    Revere, How is your SIL?

  34. #34 revere
    October 29, 2009

    Grace: Better, thanks. Back at work as of yesterday. Injury.

  35. #35 Grace RN
    October 29, 2009

    Glad to hear he is OK, despite the American Healthcare system. Equally glad you were there with him.

  36. #36 M. Randolph Kruger
    May 5, 2010

    I was waiting for this to show up. PHS in the UK now says that the system is broke and has no more money because of the swine flu pandemic. They were given their alottment of money and well, they spent it on flu. As they should have. The difference is clear here though and that is that you can bankrupt a health insurance company with this and then just back that up… Or you can bankrupt a country or as they are in the UK… refuse services.

    This is a primary link but the secondaries that fly off in all directions indicate a system that is going to collapse or you wont get that health care you were promised. They will say everything is fine. Show some granny getting her hip on TV kind of thing, but the truth will be that some doctor is on the phone trying to get something approved and it likely wont happen for a year or more.


    The fact is that neither system is perfect and I believe that those that are indigent and cant work should get healthcare for free. But we have a nation of suckers now, they suck on the GDP and at this time only 52% of the country is paying taxes thanks to the new Administration. GDP is now swallowed by entitlements of 88%… Next year? 92% and thats when the bell begins to ring. When the interest rates rise next year after the election, this Administration is going to find itself at the end of a bill that is going to have to be paid and they will have to tax everyone to get it.

    12 trillion dollars in additional spending and there really isnt anything to show for it except a tax fueled economy. When the money runs out… its over

    You are seeing the first vestiges of whats coming in Greece and the UK. 20% unemployment in Spain, 18% in Portugal. First thing to go in Greece? What was covered in their EU socialist state by their healthcare plans. Same in Spain.

    Its so nice to be so civilized that you cant get a job and get your healthcare that you were promised.

  37. #37 Luna_the_cat
    May 6, 2010

    and at this time only 52% of the country is paying taxes thanks to the new Administration

    Yeh, let’s look at the flip side of that statement, shall we? It’s the fact that 45% of the population controls less than 2% of the wealth.

    Can’t tax money that doesn’t exist, MRK. What do you have to say about the fact that this percentage of your country lives below the poverty line?

    (By the way, I live in the UK, and I am still seeing far better provision of health care services here than in the US. The fact is that our shortfalls here are more easily documented, but not more extensive, than those there.)

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